PCEM Convention Lecture

7/25/2019 PCEM Convention Lecture

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Ma. Gia Baquiran- Sison, MD MOH DPCOM

Diplomate, Philippine College of Occupational Medicine

Consultant, orld Health Organi!ation, estern Pacific "egion

Medical Director, Meralco Corporate ellness Center

Consultant, Ma#ati Medical Center

Masters in Occupational Health, $ni%ersit& of the Philippines Manila

Masters in Occupational Medicine, $ni%ersit& of 'llinois Chicago


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Outline of Presentation

Definition of the practice of OccupationalMedical

(he "ole of )mergenc& Medicine in

Occupational Medicine

Glo*al trends and Conditions that affectOccupational Medical Practice

+ocal trends in Occupational Medicine in the

Philippines

)merging health trends in the or#place

Conclusion and "ecommendations


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What is the practice of

Occupational Medicine? Occupational Medicine is a medical

discipline that emphasi!es pre%ention and

deals clinicallyand administrativelyiththe health needs of *oth indi%iduals and

groups ith respect to their or#ing

en%ironment and includes recognition,

e%aluation, control, management andreha*ilitation of occupationall&-related

diseases and inuries.


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Role of ER Medicine in

Occupational Medicine /012 3C)P esta*lished the

Occupational Medicine Committee to

e%aluate and de%elop the role of the )"ph&sician in Occupational Medicine.

/042 3C)P defined 4 areas of

)mergenc& Medicine hich is inclusi%eof an area in Occupational Medicine


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Role of ER Medicine in

Occupational Medicine 3C)P statement2 5 (he )" ph&sician

ith additional qualifications and6or

special competencies ma& engage inthe pro%ision of initial care and

continuing Occupational Medicine

ser%ices including illness and inur&

pre%ention, case management andpatient reha*ilitation.


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Initial Management of Patients at

the ER presenting with a Work-related Injury or Illness )sta*lished polic& of 3C)P last //0

Delineates )" ph&sicians7

responsi*ilities in the folloing areas2Pro%ision of emergenc& e%aluation and

treatment

Determination of medical causation)sta*lishment of ph&sical limitations

Communication ith the emplo&er

3rrangement of appropriate follo-up care


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Global Trends and ConditionsAfecting Occupational Medical

Practice Migration of 'ndustr& to de%eloping countries

Migration of or#ers 8 O97s, seamen

'ncrease in the Business process outsourcing : BPO;

*usiness

Demographic changes in near*& countries

)merging ne diseases and conditions

'ncreased (ra%el


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Top Outsourced

Industries in thePhilippines Manufacturing 'ndustr& 8 microchips, cars,

telecommunication equipment

3gricultural 'ndustr& 8 pineapple, %egeta*le oil,*iofuels

Ser%ice 'ndustr& 8 BPO :call centers;, medicaltranscription and coding, accounting6*illing

Health Ser%ices 8 medical tourism "etirement 'ndustr&


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Local Trends in

Occupational Medicine inthe Philippines 'ncrease in BPO companies :call centers; 8 SH'9( O" of the DO+)-BC Standards in

Occupational Health and Safet& and the Philippine

+a*or Code

$ 'n all or#places here there is more than or# shift

in a da&, the emplo&er shall in addition to the

requirements of the rule, pro%ide the ser%ices of a

fulltime first-aider for each or# shift.

$ or#ers >-1>2 first aider

$ 1>-?>>2 full time registered nurse

$ ?>-@>>2 full time "A, parttime MD, parttime dentist

$ @> a*o%e2 full time "A, full time MD, full time dentist


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%eneral &eatures

or# as one of the causes. Both or#ers and non-or#ers are affected.

'ncrease in the ACDs :dia*etes,

h&pertension, coronar& arter& disease in the&oung;

Has impact in health cost utili!ation

)mphasis must ala&s *e toards the

pre%enti%e side and fitness to or# should*e highl& considered.


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'op Occupational #ealth

Issues in the Workplace 'nfectious diseases

Bronchial asthma

S#in diseases

Cardio%ascular diseases

Gastrointestinal-related diseases

Cataract, deafness

3cute poisoning

(ased on the Philippine )ational O"# Pro*le+ "ept, .


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Occupational Health Issues

in the Business ProcessOutsourcing 'ncreasing num*er in ACDs :dia*etes, h&pertension in the

&oung;

Shift or# related health issues

)rgonomic-related health issues such as "epetiti%e Strain'nuries :"S';

Ps&chosocial factors :o* satisfaction, personalit& traits,

perception of intensified or#load, o* control;


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"ample "hift "chedules

in the (PO Industry 0 hour shift6 @.@ hours per ee#6 4

da&s on, @ da&s off > hour shift6 > hours per ee#6 4 da&s

on, da& off

? hours shift6 14 hours on the a%erageper ee#6 da&s on *ut rotated e%er& /

da&s


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Re-Emerging #ealth

Issues in the Workplace 'ncrease in H'-3'DS

'ncrease in "espirator& diseases, $(',

Gastrointestinal-related diseases,Cardio%ascular diseases

Persistence of O*esit& as num*er one in

annual ph&sical e=aminations

"esurgence of P(B

Su*stance a*use


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0emographics1

Population


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0emographics1 %ender


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0emographics1 Marital

"tatus


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0emographics1 2ge


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0emographics1 (ody

Mass Inde3 4(MI5


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0emographics1 (MI !y

%ender


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0emographics1 (MI !y

2ge


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"moking #istory


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"moking #istory !y 2ge


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0rinking #istory


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0rinking #istory !y

%ender


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0rinking #istory !y 2ge


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Pre6alent Illnesses

!ased on 2nnualPhysical E3amination


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Medical 7onditions !y

%ender


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2ge


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0rinking #istory


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Medical 7onditions

!ased on "moking#istory


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'op Illnesses !ased on

0octors8 0iagnosis 3cute (onsillophar&ngitis $pper "espirator& 'llness

Gastrointestinal-related Disorders

(ension Headache6 Migraine

$('

H&pertension

Conuncti%itis Musculos#eletal strain

S&stemic iral 'llness

OB-related


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'op Reasons for ER

7onduction Gastrointestinal-related disorders

Cardio%ascular-related disorders

"espirator&-related

Pregnanc&-related

3sthma

3ccidents

3naph&la=is


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'op Reasons for "ent

#ome 7ases Conuncti%itis 3(P

G'-related Disorders

$"(' (ension Headache6 Migraine

S&stemic iral 'llness

H&pertension

Musculos#eletal disorders Dental-related disorders

$('


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Occupational-related

7ontri!uting &actors "epetiti%e acti%ities Shiftor#-related

9orceful e=ertion 3#ard6static posture

(emperature e=tremes

+ocali!ed mechanical stress +ifest&le-related factors such as eating

ha*its, smo#ing and drin#ing


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)ew 'rends in Occupational

#ealth (o predict indi%idual suscepti*ilit& to a

su*stance6 certain disorders

(o estimate internal e=posure or earl&*iological effects *& molecular *io-mar#ers or *iological monitoring

Monitor e=posure especiall& forcarcinogens li#e toluene and pesticides


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)ew 'rends in Occupational#ealth 'ntroduction of Medical Case Management

9itness for or# specialt& )nforcement of health and ellness

programs in the or#place


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References in

Occupational andEn6ironmental #ealth Medline %ia Pu*Med2

.nc*i.nlm.nih.go%6entre!6quer&.fcgi

(OE+'A) and Ha!ardous Su*stances

Data Ban#2http266to=net.nlm.nih.go%6inde=.html

'"'S :'ntegrated "is# 'nformation

S&stem;2 to=ic doses of su*stances inthe en%ironment

A'OSH('C-?2 .?a.cdc.go%6nioshtic-?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgihttp://toxnet.nlm.nih.gov/index.htmlhttp://toxnet.nlm.nih.gov/index.htmlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi


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7O)79"IO)


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Documents

PCEM Convention Lecture