Block 3: Occupational Health Management - Section 5 or possibly 4: Medical Fitness Assessment
OHM5 or 4.1: Overview - concepts of fitness and their relation to risk OR TASK OR JOB REQUIREMENTS

 

 

GENERAL OBJECTIVES
To aqcuire a coherent framework by which to apply the principles of fair labour practice, in the management of employees that are incapacitated or disabled, whilst protecting the operational interests of the company..

SPECIFIC OBJECTIVES

The objectives of this section include:

  • To clarify understand the roles of the various stakeholders in the management of incapacity and disability
  • To understand the actions that should be taken by managers to ensure that incapacity and disability is actively managed, by providing knowledge and support.
  • To reduce the conflicts that arise between colleagues in the workplace, which are the result of misunderstandings and mismatched expectations regarding responsibilities and roles.
 

GENERAL OBJECTIVES

1          PURPOSE

The purpose of this policy section is to provide a coherent framework by which to guide the application of fair labour practice, in the management of employees that are incapacitated or disabled, whilst protecting the operational interests of the company.

2          OBJECTIVES

The objectives of this policy include:

 

INTRODUCTION

From the above it is clear that a central theme in the concept of “fitness to work” is that of required minimum “standards of fitness”, or “inherent requirements”. These minimum standards of fitness can be regarded as the factors that are required for specific occupations, and are determined by the liability & exposure risk profiles of those occupations. These minimum standards need to be established in a way that is fair and rationally defendable and expressed in a way that is measurable, to ensure consistent application.

The Occupational Health and Safety Act requires people in occupations that entail potential exposure to certain hazards (such as noise, lead, hazardous chemical substances and hazardous biological agents) to be subjected to medical screening, to determine their fitness to work in the said occupations.

In the mining industry, all employees involved in “risk work” are required to undergo an initial medical examination and be certified fit for work by an Occupational Medicine Practitioner prior to their engagement in risk work. This needs to be repeated at a prescribed periodicity. This process is legally prescribed in both the Occupational Diseases in Mines and Works Act (ODIMWA) and in the Mines Health and Safety Act. Historically, this certificate is known as “The Red Ticket”, a term which is derived from the document which was issued to employees by the Medical Bureau of Occupational Diseases, authorising them to perform risk work. This was a red coloured card, which certified a fitness to work for a prescribed period of time. At the end of the authorised period, the employee was required to undergo a periodic medical examination, to ensure that he/she continued to meet the minimum standards of fitness to perform risk work

 

The concept “fitness to work” implies that an occupation has inherent health requirements that need to be met by a person in that occupation, in order to minimise the risk of injury or illness. Hence, the concept of fitness is closely associated with the concept of “risk”. Before examining “fitness”, it is necessary to take a brief look at the underlying principles of “risk”. IS THIS DIFFERENT FROM THE USE OF RISK BEFORE IN HRA? MUST BEWARE OF CONFUSION No, these concepts are exactly as contemplated in the HRA section. There is a slight shift in the focus of the risk, though (liability, rather than adverse health effect).

These risks fall into two broad categories:

Exposure Risk  RISKS FLOWING FROM THE ENVIRONMENT AND AGENT Correct

This refers to risks associated with exposure to hazards in that occupation. These hazards include noise, heat, dust, ergonomic hazards, etc., and their POTENTIAL OR ACTUAL  IN RELATION TO THE DEFINITION OF RISK?Correct adverse health effects on exposed people.

Liability Risk  RISKS FLOWING FROM FACTORS INHERENT TO THE HOST WHICH ARE NECESSARY TO PERFORM THE OCCUPATIONAL TASKS SAFELY? IS THIS AN INSURANCE TERM? I confess, this a term coined by me, in a desperate attempt to convey this concept. Of course, the insurance industry would be the prime beneficiary for this for of Risk info.

Certain occupations require of the employee the capability to conduct the tasks inherent in the occupation in a manner that does not increase the likelihood of injury or illness to co-workers, as well the employee him/herself.  Failure to meet these requirements raises employer liability for claims from both outside and inside the company (accidents caused by employees physically inadequately equipped for the job). I HAVE AN UNCOMFORTABLE FEELING THAT A NUMBER OF POINTS ARE ROLLED INTO THIS WHY IS THERE NO LIABILITY IF AN EMPLOYER EXPOSES WORKERS TO CONVENTIONAL EXPOSURE RISKS BUT THERE IS FOR NOT SEEING THAT EMPLOYEES ARE ABLE TO CONDUCT THE TASKS.  THIS DISCOURSE IS ALIEN TO ME AND I WOULD LIKE TO UNDERSTAND IT BETTER The problem is that you have a brilliant eye for the incongruous!! You are correct, of course - the term suggests that the "liability" lies only in "Liability Risk", and that no "liability" is present in "Exposure Risk". This, of course, is not the case, nor is this message intended, so perhaps it is time to change the term again (have done so before!). 

The core element of "exposure risk" refers to the risks of developing adverse health effects consequent on exposure (noise, heat, dust, etc.), whereas the core element of "liable" risk refers to the risks of litigation from operator failure (airline pilot, truck driver, crane operator, etc.). The term was created simply to differentiate between the two types of risk, with the understanding that all risk carries "liability". The reason why the two types of risk require differentiation is explained below (it influences the mindset of the examining professional). Can you help me find a term? My first term for this was "Capability Risk". How does this grab you?

This dual view of risk can be seen graphically below.

Figure 1: The relationship between liable risk and exposure risk.

 

 I DON'T LIKE THIS TABLE  - IT DOES NOT REALLY MAKE THE POINT TOO WELL.AND ITS VISIBILITY IS POOR ON THE WEBPAGE. THE EXAMPLES DO NOT CLEARLY DIFFERENTIATE. AGAIN THE ORDER IS WRONG.

I am not sure what to do about this Jonny. I have been using this image for a number of years, and it has served me well. in what way does it not make the point well? Why do the examples not clearly differentiate? (they are easily chagned). What do you mean the order is wrong?

This illustrates the two basic axes of risk – the vertical axis represents increasing health requirements and the horizontal axis represents increasing potential exposure to hazards.  This leads to four main “risk-groups” of occupations:

This model shows the dual requirement of the Medical Surveillance Programme to evaluate employees for both of these axes of risk.  The programme should ensure that minimum medical requirements are met by employees, and also that any adverse health effects from the exposure to hazards in the workplace are detected at an early stage, enabling effective remedial action to be taken

REFERENCES: 

sYNERGEE Fitness Certification and Disability

Policy Guideline

1.      The Occupational Health and Safety Act (OHSA), No 85 of 1993 and Regulations.

2.      The Mines Health and Safety Act (MHSA), No. 29 of 1996 and Codes of Practice.

3.      The Labour Relations Act No 28 of 1956 as amended in 1996.

4.      The Employment Equity Act 55 of 1998.

5.      The Codes of Good Labour Practice (including Hours of Work, Pregnancy, HIV & testing, Disability, etc.)

6.      The Basic Conditions of Employment Act 75 of 1997 (BCOEA)

7.      The National Road Traffic Act No. 93 of 1996, and Regulations.