A 34 year old man works for X as a Customer Service Adviser in the contact centre. He has been absent on a self certificate for one week and has just submitted a sick line (Med 3) for 2 weeks.
His employer, under their musculoskeletal policy, refer him to Integral OH upon receipt of the Med 3.
He is assessed by one of the OH Physicians who is able to examine and advise that the employee has simple back pain, which is not serious or progressive. The OH doctor advises him on appropriate exercises and encourages increased activity. The employee is also provided with a copy of The Back Book.
The doctor advises the employee he is fit for a return to work with minor modifications. He needs to get up and move around for a minute a couple of times an hour for the next 2-3 weeks.
The employer does not need to wait for the expiry of the medical certificate prior to a return to work and the employee returns and is actually back at full productivity a week before the expiry of the sick line.
An employee is working for a support organisation and has been notified that there will be a need for an investigation into some ‘financial irregularity’ with a service user’s money. The following day, the employee submits a medical certificate from her GP advising ‘work related stress’ and ‘unfit for 4 weeks’.
The employee is seen in Occupational Health . The employee is distressed by the situation but the physician advises the employee does not satisfy any diagnosis of a mental health disorder such as depression.
The doctor assesses that the employee satisfies the following ‘fitness to take part in hearings’ standard and is therefore fit to take part in the hearing:
The OH doctor advises the employee that the best way to address the stress is to have the hearing completed as soon as possible and also suggests that the employer considers a neutral venue and also advance notice of questions to be asked.
The OH Physician also finds the employee medically fit for work and writes to the GP advising of their view and the reasoning behind this.The process goes ahead and after the investigation it is found there is not a case to answer by the employee who duly returns to work.
The situation is addressed with a 2 week absence from work and the employee returns 2 weeks before the expiry of the first certificate and the employees stress problem is addressed promptly.
Proteins from fish and shellfish are well recognised as causes of Occupational Asthma in process workers.
A new employee commences with a fish processing factory. The Integral nurse, on site, carries out baseline health surveillance including breathing tests and a questionnaire, which are all normal. The employee is advised that she needs to notify OH is she develops any nose, eye or breathing symptoms.
The Integral protocol requires a respiratory assessment for asthma at 6 weeks and 12 weeks from commencement of work.
At the 6 week check, the OH Nurse notices the employee has stated on their questionnaire they have itching of the eyes, runny nose and coughing, all of which get better away from work. The OH nurse discusses the case with the lead OH Physician who advises serial peak flow measurements.
The results are computer analysed after 4 weeks and they show Occupational Asthma. The OH Physician carries out an allergy blood test (IgE) for prawn, which is positive.
On the basis of the tests, the employee is diagnosed with Occupational Asthma. She is moved away from prawn processing to dispatch, thus avoiding any significant prawn exposure. She remains under health surveillance every 6 months but her symptoms have resolved.
The employee has avoided inevitable worsening of her asthma and is able to still work. The employer has greatly reduced their liability for Occupational Asthma by ensuring they have contracted an appropriate OH provider which has picked up Occupational Asthma at the earliest opportunity.
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