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Occupational Medical Examinations

Occupational Medical Examinations. Kayvan Karamifar, M.D Occupational Medicine Specialist Petroleum Industry Health Organization. Categories of Medical Examinations. Pre-employment/ Employment entrance exam Periodic Examinations Preplacement Examinations Return to work examinations

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Occupational Medical Examinations

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  1. Occupational Medical Examinations Kayvan Karamifar, M.D Occupational Medicine Specialist Petroleum Industry Health Organization

  2. Categories of Medical Examinations • Pre-employment/ Employment entrance exam • Periodic Examinations • Preplacement Examinations • Return to work examinations • Exit examination

  3. Employment Entrance Examinations

  4. Employment Entrance Exam Purposes: • Determination of individual’s physical and emotional capacity to perform a particular job • Establishing a baseline record of physical condition for • to compare periodic health exam records • Epidemiologic and medico legal purpose • Assessing the individual’s general health

  5. Physical and Emotional Capacity Primary purpose of preplacement exam • Physical capacity: • Individuals can perform the work safely; without harm to themselves or to others • Rejection of employment has not permitted because of condition which don’t have a direct bearing upon the person’s capacity to perform that job (ADA)

  6. Determination ofPhysical and Emotional Capacity • Determine physical capacity • Determine job demands • Categorize significant impairments • Stable impairment (amputation, deafness…) Ensure reasonable efficiency &safety • Impairment that may be worse by the work exposures ensure employee’s condition is not made worse by this work • Progressive conditions (COPD,CHF) Stage & progression &prognosis • Intermittent impairment that may result in incapacity (epilepsy) • Direct threat determine duration& nature& severity& imminence of the threat • Decision making

  7. Baseline Record of Physical Condition • Comparison of baseline data with results of periodic health exam • Early detection of occupational disease • Detection of unknown health effects of new exposures • Medico legal purpose

  8. مراحل انجام معاینات بدواستخدام • معرفی نامه عکس دار و ممهورامور اداری و اعلام سمت پیشنهادی • فرم معرفی شاغلین برای انجام معاینات شغلی • شرح وظایف سمت پیشنهادی • انجام شرح حال ومعاینات فیزیکی • آزمایشات و تستهای پاراکلینیک لازم • مشاوره های تخصصی در صورت نیاز • اظهار نظر نهایی

  9. حداقل معاینات فیزیکی لازم

  10. حداقل معاینات فیزیکی لازم

  11. A patient with normal function can reach approximately the level of the T4 spinous process. To assess internal rotation and adduction, the patient is asked to reach behind her back and touch the inferior tip of the opposite scapula (photograph C). A patient with normal function can reach approximately the level of the T8 spinous process.

  12. Neer's impingement sign is elicited when the patient's rotator cuff tendons arepinched under the coracoacromial arch. The test is performed by placing the arm inforced flexion with the arm fully pronated .The scapula should bestabilized during the maneuver to prevent scapulothoracic motion. Pain with thismaneuver is a sign ofsubacromial impingement. Neer's TestMost Reliable impingement test

  13. Examination for Scoliosis

  14. Prone Knee Bend test

  15. حداقل آزمایشات وپاراکلینیک لازم • گرافی قفسه سینه فقط در موارد زیر: • مشاغل عملیاتی که با عوامل زیان آور تنفسی مواجهه دارند • وجود علائم ریوی ( به تشخیص پزشک ) • سابقه مجروحیت شیمیایی در جنگ

  16. آزمایشات و تست های اختصاصی • - علاوه بر حداقل تست ها و آزمایشات • -تست های اختصاصی: • - تست ورزش یا ارگومتری در سمت های مربوط به مشاغل ویژه • آتش نشان – حراست – غواص • - تست های بررسی عملکرد شیپور استاش در غواص • - گرافی شانه – هیپ وزانو در غواصان

  17. اظهار نظر نهایی ( Fitness Comment ) • پس از انجام کلیه مراحل و آماده شدن پاسخ آزمایشات وتست ها • پس از دریافت پاسخ کلیه مشاوره های تخصصی انجام شده • با توجه کامل به نتایج ارزیابی ها و نوع و خصوصیات شغل پیشنهادی • هر بیماری الزاما منجر به منع استخدام برای شاغل نمی شود. • به دلیل تنوع بسیار در بیماری ها ومشاغل ، در موارد مشکوک به منع استخدام جهت تصمیم گیری ، حتما قبل از هر گونه اظهار نظر مشاوره طب کار انجام شود.

  18. Periodic Examinations

  19. Periodic Health Examinations • General • Health maintenance program • Where there is possibility of subtle/ unknown hazards • Hazard related • Monitor employee health in relation to specific hazards

  20. Important Steps • Identifying hazards and risks • Identifying the best procedure to detection of specific health effects in early stage • Identifying the qualified persons to perform tests • Analyze data • Appropriate recommendation

  21. مراحل انجام معاینات دوره ای • فرم معرفی شاغلین برای انجام معاینات شغلی ممهور به مهر HSE • انجام شرح حال ومعاینات فیزیکیبر اساس مواجهه • آزمایشات و تستهای پاراکلینیک لازم بر اساس مواجهه • مشاوره های تخصصی در صورت نیاز • اظهار نظر نهایی

  22. Return to Work Examinations(RTW Exam) After absence for a serious illness • Determine Physical capacity • Determine job demands • Determine convalescence period & follow-up process • Determine rehabilitation process if needed

  23. موارد لزوم انجام معاینات بازگشت به کار

  24. Exit exam • Medico legal purpose

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