OEH Training Summary Thoughts - PowerPoint Presentation

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OEH Training Summary ThoughtsHong Kong29 October 2013

Thomas H Gassert MD MSc

Harvard School of Public Health

OEH Diagnosis and CausationTwo steps:Medical diagnosis requires quality OEH training

Causation (work related, or not) should be an impartial judgment

Need to use subject and group information

Epidemiology, toxicology, risk assessmentUnderstanding work place and job imperativeCausation is a judgment (more probable than not):Strength of associationConsistencySpecificityTime relationshipBiological gradientBiological plausibilityCoherence (synthesis of evidence)

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Obstacles for Parties to OEH

Government

Enterprise/Work

Labour/NGOsMedical/PreventionContradictory OEH laws and practicesPoor treatment, abuse and threats

Bear burden of disease; lack of primary OEH protection

Lack of OD diagnostic knowledge and skills and primary OEH prevention

Inadequate OEH standards

and policies

Fear of worker rights realization and protests/claimsFear of job loss, discriminationAlmost no one trained in OEH prevention/careNo whistleblower protection, and other political abusesDo not understand $ and social value of OEH Lack of OEH prevention methods, rights, hazard risk knowledge, and how to relate to medical providers Those trained are overwhelmed, not dedicated, or co-opted; fear of legal and defamation repercussions

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OEH Motivation & Advantages

Government

Enterprise/Work

Labour/NGOMedical/PreventionLift cost of diseaseLeadership

Leadership

LeadershipStandards upgrading

Reputation

Trainable in

OEH, tailored to culture, language, job conditions, literacy (example, Hesperian book model)Trainable in OEH if they know they can help workers without penalty; case based is holistic; see one, do one, teach oneMedical practice regulatory reformsCost advantagesHighly motivatedNeed OEH teamwork and PHC integration Trainable in OEHPress: work place

publicNeed standards and credentials

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Approaches – Two?Obstacles are seriousTwo approaches

Root levels, subtle but strong, holistic, integrated, from bottom-up

Choose motivated partners from all parties

Start with work-site OEH skills (e.g., safety reps)Empower workers with knowledge of OEH recognition, diagnoses and how to relate with OSH profs and medicalEmphasize training primary care in OEHPublic

Campaigns, expert and grassroots publications, ratings, media, handbooks (Hesperian style), videos

Call out abuses and reward good practices using science and experts (medical and legal)

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Projects - ?Signed resolution stating need for trainingIdentify rapid and practical ways to integrate OEH training locally with existing PHC services

Complete baseline needs assessment, nation-by-nation (publish and post)

Assemble an interim international OE medical panel to assist urgent cases and disasters

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Possible SolutionsRoot work to educate all parties

OEH/OSH prevention skills (1, 2, 3 levels)

Technical skills and knowledge transfer

Shop floorMedics, hygienists, engineers, managers, gov’t workersRaise legal (labour and OEH law) and medical standardsOD diagnoses (see WHO handout from Finland)Access to health care and primary prevention expertsAccreditation/certification of medical teamsIntegrate and embed OEH training in primary care serviceConsider Taiwan NODIS internet OD reporting system as it has had significant boost to OD diagnosis and compensation (see handout article from IJOEH 2013)

Bring “value-added” achievable projects to funders Funds will come if payors

see value-added (benefits outweigh costs)Establish new generation of OEH specialists by having national capacity building in OEH training, certification and materials

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Work Site Technical TrainingWalk-through survey and checklists

OSH committee (

labour

and management)Periodic inspectionsAccess to experts and records/reportsOccupational hygiene, safety manager, consultantNursing, Rehab, MedicalWorker has right to his/her medical and exposure recordsHazard Communication tools, accessBarefoot epidemiologyEach caseGroup applications

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Final ThoughtTraining and FundingJump start for OEH at all levels

Eliminate costs and financially support those being trained in OEH skills/knowledge

Use international support to eventually build national competencies/capacity

New Generation Univ – U. British Columbia linked with superior programs for certifications (Harvard, U.I. Chicago, U. Wash., others)Work with Partners in Health to create Partners in Occupational & Environmental HealthRealize human rights to OEHAccess funding from World Bank for team training29 Oct 2013 HK THG

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17 Ways NextGenU Differs from MOOCs*

and Traditional Education

Credit

Free

Financial sustainability

Higher level educationBest available resources

Coordinated curriculum

Competency-based foundation

Multiple languagesExtensive human interactionsInteractive computerized learningExtensive computer and human assessmentOpen use Customizable

Active educational partnerships A new way to teach

Open research policy

Warm prestige

*MOOCs=Massive Open Online Courses

Seek Free Methods29 Oct 2013 HK THG

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4 Freedoms

Cost

Barriers

Ads

Carbon

New Gen U

Partnerships

MotivationFeel impoweredFeel motivated

Try not to feel overwhelmed

Seek global support, partners

Integrate environment with occupationalThere’s no turning back!29 Oct 2013 HK THGOEH Summary Thoughts12