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Physician Services Corporate Health Center ’s Medical Director, Carol A. Currier, MD, MPH, CIME is trained and experienced in the specialty of Occupational and Preventive Medicine. In addition, Dr. Currier is familiar with the FAA and has decades of experience with the specific requirements of the agency. As illness and injury prevention demands that health care providers understand the work-place, its processes and the inherent risks to the workers, periodic work place walk-through surveys are another feature of our environmental, health and safety program. Treatment
services for work related illnesses and injuries to the
workforce (including Case Management, Workers' Compensation and
OSHA reporting, and return to work) are paramount to our practice.
Effective case management can return sick or injured employees
to work quickly. Cooperation with employers is essential to identify
meaningful jobs for employees with temporary restrictions. Investigation
of even the most minor of illnesses or injuries is an important
part of preventing future health problems in the work place. Surveillance physicals are only a small part of a comprehensive surveillance program, but are the most important way to detect unsuspected exposures or early health risks. The results of the exams should be reported to the worker and records available to the personal physician. If the exams are not performed on-site then some mechanism to have the results reviewed by CHC’s Medical Director should be in place. The extent of worker and work place surveillance will vary with the environmental and physical risks to the worker. There may be confusion regarding the nomenclature used in a surveillance program. This can best be avoided by written guidelines and procedures that define terms. A generally accepted set of definitions for monitoring programs2 is as follows: Clinical Monitoring is a standard complete physical including review of the employee's health history and a hands-on examination. Medical Monitoring is sometimes called health effects monitoring and includes standard blood chemistries for hepatic, renal, metabolic and other organ function, as well as electrocardiographic and pulmonary function testing. The test results are compared to population norms and to baseline results established on the individual worker. Biologic Monitoring is sometimes called biochemical effects monitoring. It refers to the evaluation of specific environmental exposures through measurements of the agents (e.g. lead, cadmium, cholinesterase, etc.) or their metabolites in biological samples. The results are compared to reference values known as biological exposure indices (BEIs). Environmental
Monitoring is the estimation of exposure by sampling
of the workplace environment for known or suspected hazardous
agents. The results are compared with the published threshold
limit values or TLV (ACGIH), or the permissible exposure level
or PEL (OSHA). The health education and wellness program may be very limited or quite extensive. There is increasing evidence that good programs can be cost effective. However, there is little data to indicate that programs are effective in reducing costs of illness care if they do not offer baseline health risk appraisals (HRA) to identify persons at increased risk of cardiac and/or behavioral events. Aggressive educational programs to reduce risks (concentrating on the high-risk group), and documentation of the risk reduction through follow-up testing are essential components of effective programs. Such programs require the participation of a high percentage of employees and the cooperation of their personal physicians.
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