Skip to main content
Top
Published in: Journal of Occupational Rehabilitation 1/2012

01-03-2012

Work-Related Primary Care in Occupational Health Physician’s Practice

Authors: Annukka Ikonen, Kimmo Räsänen, Pirjo Manninen, Maria Rautio, Päivi Husman, Anneli Ojajärvi, Kaj Husman

Published in: Journal of Occupational Rehabilitation | Issue 1/2012

Login to get access

Abstract

Introduction Primary care is frequently integrated in Finnish occupational health services (OHS). This study examines the frequency of work-related health problems in occupational health (OH) physicians’ consultations for primary care and associations between health problems and interventions carried out by OH physicians. Methods OH physicians assessed the health problems of 651 consecutive visits in a private OHS unit. The health problem was regarded as work-related if it was caused or aggravated by work, or involved impaired work ability. Interventions carried out by OH physicians were analysed by logistic regression analysis. Results The main health problem was caused either partially or mainly by work or symptoms were worsened by work (27%), or symptoms impaired work ability (52%). Musculoskeletal and mental disorders were the main work-related reasons for visits. In two-thirds of the cases of mental health problems, work caused or worsened symptoms, and the majority of long sickness absences were issued due to these problems. OH physicians carried out interventions concerning work or workplace in 21% of visits. Mental disorders were associated most strongly (OR 7.23, 95% CI 3.93–13.32) with interventions. The strongest association (OR 16.09, 95% CI 9.29–27.87) with work-related visits was, when the health problem was both work-induced and impaired work ability. Conclusions Work-related health problems comprise a considerable part of Finnish OH physicians’ work. OH physicians play an important role in early treatment, in the prevention of disability, and in interventions aimed at workplaces based on the knowledge they get through primary care in OHS.
Literature
1.
go back to reference Identification and control of work-related diseases. Report of a WHO Expert Committee, WHO Technical Report series 714. Geneva: WHO; 1985. Identification and control of work-related diseases. Report of a WHO Expert Committee, WHO Technical Report series 714. Geneva: WHO; 1985.
3.
go back to reference Hussey L, Turner S, Thorley K, McNamee R, Agius R. Work-related ill health in general practice, as reported to a UK-wide surveillance scheme. Br J Gen Pract. 2008;58(554):637–40.PubMedCrossRef Hussey L, Turner S, Thorley K, McNamee R, Agius R. Work-related ill health in general practice, as reported to a UK-wide surveillance scheme. Br J Gen Pract. 2008;58(554):637–40.PubMedCrossRef
4.
go back to reference Chen Y, Turner S, McNamee R, Ramsay CN, Agius RM. The reported incidence of work-related ill-health in Scotland (2002–2003). Occup Med (Lond). 2005;55(4):252–61.CrossRef Chen Y, Turner S, McNamee R, Ramsay CN, Agius RM. The reported incidence of work-related ill-health in Scotland (2002–2003). Occup Med (Lond). 2005;55(4):252–61.CrossRef
5.
go back to reference Won JU, Dembe AE. Services provided by family physicians for patients with occupational injuries and illnesses. Ann Fam Med. 2006;4(2):138–47.PubMedCrossRef Won JU, Dembe AE. Services provided by family physicians for patients with occupational injuries and illnesses. Ann Fam Med. 2006;4(2):138–47.PubMedCrossRef
6.
go back to reference Charles J, Pan Y, Britt H. Work related encounters in general practice. Aust FamPhysician. 2006;35(12):938–9. Charles J, Pan Y, Britt H. Work related encounters in general practice. Aust FamPhysician. 2006;35(12):938–9.
7.
go back to reference Hilt B, Kvenild K, Stenersen H. Illness related to occupational factors encountered in a general practice setting. Tidsskr Nor Laegeforen. 2003;123(15):2065–7.PubMed Hilt B, Kvenild K, Stenersen H. Illness related to occupational factors encountered in a general practice setting. Tidsskr Nor Laegeforen. 2003;123(15):2065–7.PubMed
8.
go back to reference Andrea H, Beurskens AJ, Metsemakers JF, van Amelsvoort LG, van den Brandt PA, van Schayck CP. Health problems and psychosocial work environment as predictors of long term sickness absence in employees who visited the occupational physician and/or general practitioner in relation to work: a prospective study. Occup Environ Med. 2003;60(4):295–300.PubMedCrossRef Andrea H, Beurskens AJ, Metsemakers JF, van Amelsvoort LG, van den Brandt PA, van Schayck CP. Health problems and psychosocial work environment as predictors of long term sickness absence in employees who visited the occupational physician and/or general practitioner in relation to work: a prospective study. Occup Environ Med. 2003;60(4):295–300.PubMedCrossRef
9.
go back to reference Lamberg M, Leino T, Husman K. The Finnish occupational health system—challenges and approaches. Policy Pract Health Saf. 2007;5(1 Supplement):39–51. Lamberg M, Leino T, Husman K. The Finnish occupational health system—challenges and approaches. Policy Pract Health Saf. 2007;5(1 Supplement):39–51.
10.
go back to reference Hämäläinen R. The Europeanisation of occupational health services: a study of the impact of EU policies. People and work research reports 82. Helsinki: Finnish Institute of Occupational Health; 2008. Hämäläinen R. The Europeanisation of occupational health services: a study of the impact of EU policies. People and work research reports 82. Helsinki: Finnish Institute of Occupational Health; 2008.
11.
go back to reference Griffith K, Strasser PB. Integrating primary care with occupational health services: a success story. AAOHN J. 2010;58(12):519–23.PubMedCrossRef Griffith K, Strasser PB. Integrating primary care with occupational health services: a success story. AAOHN J. 2010;58(12):519–23.PubMedCrossRef
12.
go back to reference Tu HT, Boukus ER, Cohen GR. Workplace clinics: a sign of growing employer interest in wellness. Res Briefs. 2010;(17):1–16. Tu HT, Boukus ER, Cohen GR. Workplace clinics: a sign of growing employer interest in wellness. Res Briefs. 2010;(17):1–16.
13.
go back to reference Kimanen A, Manninen P, Räsänen K, Rautio M, Husman P, Husman K. Factors associated with visits to occupational health physicians in Finland. Occup Med (Lond). 2010;60(1):29–35.CrossRef Kimanen A, Manninen P, Räsänen K, Rautio M, Husman P, Husman K. Factors associated with visits to occupational health physicians in Finland. Occup Med (Lond). 2010;60(1):29–35.CrossRef
14.
go back to reference Räsänen K, Peurala M, Notkola V, Husman K, Virolainen R, Kankaanpää E. Työterveyslääkärin ja -hoitajan työnkuva (The work profile of occupational health physicians and nurses; in Finnish with an English summary). Työ ja ihminen. 1990;2:171–90. Räsänen K, Peurala M, Notkola V, Husman K, Virolainen R, Kankaanpää E. Työterveyslääkärin ja -hoitajan työnkuva (The work profile of occupational health physicians and nurses; in Finnish with an English summary). Työ ja ihminen. 1990;2:171–90.
15.
go back to reference Martimo KP, Varonen H, Husman K, Viikari-Juntura E. Factors associated with self-assessed work ability. Occup Med (Lond). 2007;57(5):380–2.CrossRef Martimo KP, Varonen H, Husman K, Viikari-Juntura E. Factors associated with self-assessed work ability. Occup Med (Lond). 2007;57(5):380–2.CrossRef
16.
go back to reference Cherry NM, McDonald JC. The incidence of work-related disease reported by occupational physicians, 1996–2001. Occup Med (Lond). 2002;52(7):407–11.CrossRef Cherry NM, McDonald JC. The incidence of work-related disease reported by occupational physicians, 1996–2001. Occup Med (Lond). 2002;52(7):407–11.CrossRef
17.
go back to reference Ha C, Roquelaure Y, Leclerc A, Touranchet A, Goldberg M, Imbernon E. The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network. Occup Environ Med. 2009;66(7):471–9.PubMedCrossRef Ha C, Roquelaure Y, Leclerc A, Touranchet A, Goldberg M, Imbernon E. The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network. Occup Environ Med. 2009;66(7):471–9.PubMedCrossRef
18.
go back to reference Harber P, Rose S, Bontemps J, Saechao K, Liu Y, Elashoff D, et al. Occupational medicine practice: one specialty or three? J Occup Environ Med. 2010;52(7):672–9.PubMedCrossRef Harber P, Rose S, Bontemps J, Saechao K, Liu Y, Elashoff D, et al. Occupational medicine practice: one specialty or three? J Occup Environ Med. 2010;52(7):672–9.PubMedCrossRef
19.
go back to reference Moriguchi J, Ikeda M, Sakuragi S, Takeda K, Muto T, Higashi T, et al. Activities of occupational physicians for occupational health services in small-scale enterprises in Japan and in the Netherlands. Int Arch Occup Environ Health. 2010;83(4):389–98.PubMedCrossRef Moriguchi J, Ikeda M, Sakuragi S, Takeda K, Muto T, Higashi T, et al. Activities of occupational physicians for occupational health services in small-scale enterprises in Japan and in the Netherlands. Int Arch Occup Environ Health. 2010;83(4):389–98.PubMedCrossRef
20.
go back to reference Alavinia SM, de Boer AG, van Duivenbooden JC, Frings-Dresen MH, Burdorf A. Determinants of work ability and its predictive value for disability. Occup Med (Lond). 2009;59(1):32–7.CrossRef Alavinia SM, de Boer AG, van Duivenbooden JC, Frings-Dresen MH, Burdorf A. Determinants of work ability and its predictive value for disability. Occup Med (Lond). 2009;59(1):32–7.CrossRef
21.
go back to reference Kivimäki M, Ferrie JE, Hagberg J, Head J, Westerlund H, Vahtera J, et al. Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population. J Epidemiol Community Health. 2007;61(10):915–20.PubMedCrossRef Kivimäki M, Ferrie JE, Hagberg J, Head J, Westerlund H, Vahtera J, et al. Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population. J Epidemiol Community Health. 2007;61(10):915–20.PubMedCrossRef
22.
go back to reference Kivimäki M, Forma P, Wikström J, Halmeenmäki T, Pentti J, Elovainio M, et al. Sickness absence as a risk marker of future disability pension: the 10-town study. J Epidemiol Community Health. 2004;58(8):710–1.PubMedCrossRef Kivimäki M, Forma P, Wikström J, Halmeenmäki T, Pentti J, Elovainio M, et al. Sickness absence as a risk marker of future disability pension: the 10-town study. J Epidemiol Community Health. 2004;58(8):710–1.PubMedCrossRef
24.
go back to reference Statistical Yearbook of the Social Insurance Institution 2009, Official Statistics of Finland. Helsinki: Social Protection; 2010. Statistical Yearbook of the Social Insurance Institution 2009, Official Statistics of Finland. Helsinki: Social Protection; 2010.
25.
go back to reference Mortelmans AK, Donceel P, Lahaye D, Bulterys S. Work-related sickness absences and mandatory occupational health surveillance. Occup Med(Lond). 2008;58(7):464–7.CrossRef Mortelmans AK, Donceel P, Lahaye D, Bulterys S. Work-related sickness absences and mandatory occupational health surveillance. Occup Med(Lond). 2008;58(7):464–7.CrossRef
26.
go back to reference Räsänen K, Notkola V, Husman K. Work-related interventions during office visits to occupational health physicians. Prev Med. 1997;26:333–9.PubMedCrossRef Räsänen K, Notkola V, Husman K. Work-related interventions during office visits to occupational health physicians. Prev Med. 1997;26:333–9.PubMedCrossRef
27.
go back to reference Harber P, Mullin M, Merz B, Tarazi M. Frequency of occupational health concerns in general clinics. J Occup Environ Med. 2001;43(11):939–45.PubMedCrossRef Harber P, Mullin M, Merz B, Tarazi M. Frequency of occupational health concerns in general clinics. J Occup Environ Med. 2001;43(11):939–45.PubMedCrossRef
28.
go back to reference Martimo KP, Husman K, Antti-Poika M. Medical consultations in occupational health services. Third International Congress on Health Services Research and Evaluation in Occupational Health, Glasgow, Scotland, November 22–26, 1995 (Abstract). Martimo KP, Husman K, Antti-Poika M. Medical consultations in occupational health services. Third International Congress on Health Services Research and Evaluation in Occupational Health, Glasgow, Scotland, November 22–26, 1995 (Abstract).
29.
go back to reference Takala EP, Viikari-Juntura E, Moneta GB, Saarenmaa K, Kaivanto K. Seasonal variation in neck and shoulder symptoms. Scand J Work Environ Health. 1992;18(4):257–61.PubMedCrossRef Takala EP, Viikari-Juntura E, Moneta GB, Saarenmaa K, Kaivanto K. Seasonal variation in neck and shoulder symptoms. Scand J Work Environ Health. 1992;18(4):257–61.PubMedCrossRef
31.
go back to reference Manninen P, editor. Työterveyshuolto Suomessa vuonna 2007 ja kehitystrendi 1997–2007 (Occupational Health Services, in Finland in 2007—a survey of the structure, inputs and outputs). Helsinki: Työterveyslaitos, STM; 2009. Manninen P, editor. Työterveyshuolto Suomessa vuonna 2007 ja kehitystrendi 1997–2007 (Occupational Health Services, in Finland in 2007—a survey of the structure, inputs and outputs). Helsinki: Työterveyslaitos, STM; 2009.
32.
go back to reference Chen Y, Agius R, McNamee R, Turner S, Taylor S, Fulluck L, et al. Physicians’ beliefs in the assessment of work attribution when reporting musculoskeletal disorders. Occup Med (Lond). 2005;55(4):298–307.CrossRef Chen Y, Agius R, McNamee R, Turner S, Taylor S, Fulluck L, et al. Physicians’ beliefs in the assessment of work attribution when reporting musculoskeletal disorders. Occup Med (Lond). 2005;55(4):298–307.CrossRef
33.
go back to reference O’Neill E, McNamee R, Agius R, Gittins M, Hussey L, Turner S. The validity and reliability of diagnoses of work-related mental ill-health. Occup Environ Med. 2008;65(11):726–31.PubMedCrossRef O’Neill E, McNamee R, Agius R, Gittins M, Hussey L, Turner S. The validity and reliability of diagnoses of work-related mental ill-health. Occup Environ Med. 2008;65(11):726–31.PubMedCrossRef
34.
go back to reference Palmer KT, Reading I, Calnan M, Coggon D. How common is repetitive strain injury? Occup Environ Med. 2008;65(5):331–5.PubMedCrossRef Palmer KT, Reading I, Calnan M, Coggon D. How common is repetitive strain injury? Occup Environ Med. 2008;65(5):331–5.PubMedCrossRef
35.
go back to reference Mehlum IS, Veiersted KB, Waersted M, Wergeland E, Kjuus H. Self-reported versus expert-assessed work-relatedness of pain in the neck, shoulder, and arm. Scand J Work Environ Health. 2009;35(3):222–32.PubMedCrossRef Mehlum IS, Veiersted KB, Waersted M, Wergeland E, Kjuus H. Self-reported versus expert-assessed work-relatedness of pain in the neck, shoulder, and arm. Scand J Work Environ Health. 2009;35(3):222–32.PubMedCrossRef
36.
go back to reference Hussey L, Turner S, Thorley K, McNamee R, Agius R. Comparison of work-related ill health reporting by occupational physicians and general practitioners. Occup Med (Lond). 2010;60(4):294–300.CrossRef Hussey L, Turner S, Thorley K, McNamee R, Agius R. Comparison of work-related ill health reporting by occupational physicians and general practitioners. Occup Med (Lond). 2010;60(4):294–300.CrossRef
37.
go back to reference Pärnänen H, Mäntyselkä P, Kumpusalo E, Takala J. Terveyskeskuslääkärissäkäyntien syyt Suomessa (Reasons to visit health centre physicians in Finland, in Finnish). Suom Lääkäril. 2001;56(35):3483–7. Pärnänen H, Mäntyselkä P, Kumpusalo E, Takala J. Terveyskeskuslääkärissäkäyntien syyt Suomessa (Reasons to visit health centre physicians in Finland, in Finnish). Suom Lääkäril. 2001;56(35):3483–7.
38.
go back to reference Weevers HJ, van der Beek AJ, Anema JR, van der Wal G, van Mechelen W. Work-related disease in general practice: a systematic review. FamPract. 2005;22(2):197–204. Weevers HJ, van der Beek AJ, Anema JR, van der Wal G, van Mechelen W. Work-related disease in general practice: a systematic review. FamPract. 2005;22(2):197–204.
39.
go back to reference Roelen CA, Koopmans PC, Anema JR, van der Beek AJ. Recurrence of medically certified sickness absence according to diagnosis: a sickness absence register study. J Occup Rehabil. 2010;20(1):113–21.PubMedCrossRef Roelen CA, Koopmans PC, Anema JR, van der Beek AJ. Recurrence of medically certified sickness absence according to diagnosis: a sickness absence register study. J Occup Rehabil. 2010;20(1):113–21.PubMedCrossRef
40.
go back to reference Anema JR, Jettinghoff K, Houtman ILD, Schoemaker CG, Buijs PC, van den Berg R. Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil. 2006;16(1):41–52.PubMedCrossRef Anema JR, Jettinghoff K, Houtman ILD, Schoemaker CG, Buijs PC, van den Berg R. Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil. 2006;16(1):41–52.PubMedCrossRef
41.
go back to reference Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med. 2003;60(1):3–9.PubMedCrossRef Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med. 2003;60(1):3–9.PubMedCrossRef
42.
go back to reference Silverstein B, Clark R. Interventions to reduce work-related musculoskeletal disorders. J Electromyogr Kinesiol. 2004;14(1):135–52.PubMedCrossRef Silverstein B, Clark R. Interventions to reduce work-related musculoskeletal disorders. J Electromyogr Kinesiol. 2004;14(1):135–52.PubMedCrossRef
43.
go back to reference Kant I, Jansen NW, van Amelsvoort LG, van Leusden R, Berkouwer A. Structured early consultation with the occupational physician reduces sickness absence among office workers at high risk for long-term sickness absence: a randomized controlled trial. J Occup Rehabil. 2008;18(1):79–86.PubMedCrossRef Kant I, Jansen NW, van Amelsvoort LG, van Leusden R, Berkouwer A. Structured early consultation with the occupational physician reduces sickness absence among office workers at high risk for long-term sickness absence: a randomized controlled trial. J Occup Rehabil. 2008;18(1):79–86.PubMedCrossRef
Metadata
Title
Work-Related Primary Care in Occupational Health Physician’s Practice
Authors
Annukka Ikonen
Kimmo Räsänen
Pirjo Manninen
Maria Rautio
Päivi Husman
Anneli Ojajärvi
Kaj Husman
Publication date
01-03-2012
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 1/2012
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-011-9325-1

Other articles of this Issue 1/2012

Journal of Occupational Rehabilitation 1/2012 Go to the issue