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Manual for primary health care on Basic Occupational Health Services. Encouraging publication from India, focused on informal occupations

Manual for primary health care on Basic Occupational Health Services. Encouraging publication... Objective: To discuss a new book from India intended to inform and educate primary health care professionals on workers’ health problems, with the aim to encourage new initiatives. Study design: The book is considered against the background of international developments and evaluated on the usefulness for practice and policy development. Results: The publication focuses on the 90% of the workers in India working informal, without a contract or social security, and often exposed to poor working conditions. It is the final aim of the book to prioritize care for those at the highest risk. For informal workers specialized occupational health services are absent. Therefore, primary health care might take care of basic facilities on workers’ health, when educated and adequately supported by online information, occupational health experts and clinical referral services. Such new developments started as well in other countries such as China, Thailand, Iran and Indonesia, encouraged by WHO, WONCA (family physicians), ILO and ICOH (occu- pational health experts). In the book working conditions are described in 22 branches of economic activities in India with many informal workers like agriculture, leather and tanning industry, oil mills and street vendors. Next, associ- ated health complaints and occupational diseases are explained. This information is relevant for family physicians to be able to recognize work-relatedness of health complaints and diseases. Numerous diseases can be work related such as asthma, depressive disorders, dermatitis, a variety of musculoskeletal disorders, hearing impairment, cancer of many organs, various infectious and neurological diseases. Diagnosis, treatment and prevention can be improved in primary health care, as well as advising in return to work activities. More detailed information on specific occupational or work-related diseases is given in clinical chapters. Comments are given to improve the usefulness in supporting new practices and policies. Conclusion: This book from India fits well in worldwide developments promoting the integration of forms of work - ers’ health care in primary health care. Keywords: Primary health care, Family physician, Community health care, Occupational health, Workers’ health, Informal worker, Occupational diseases, Prevention, Return to work Background Indian Association of Occupational Health published a Like many other countries, India has a serious occupa- book (391 pages) on Basic Occupational Health Services tional health service coverage problem. Therefore, the for the informal Industry [1]. The book and associated pro - ject can be appreciated within the WHO strategy of Uni- versal Health Coverage, focusing on workers’ health [2]. *Correspondence: v.dijk.workandhealth@gmail.com Learning and Developing Occupational Health (LDOH) Foundation, The Basic Occupational Health Services (BOHS) strategy Speelkamp 28, 3831, PE, Leusden, The Netherlands of World Health Organization (WHO), International Labor Full list of author information is available at the end of the article © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 2 of 4 Organization (ILO) [3] and  International Commission on principles and health surveillance. Instruments such as Occupational Health (ICOH) [4] is the chosen fundament occupational history taking, occupational hygiene tools of the project. Primary health care is considered as a first and monitoring are shortly described. level of “workers’ health care” for the about 85% of 3.1 bil- A second objective is to inform primary health care lion workers worldwide who are not supported by expert- about a wide range of concrete risks at workplaces where based Occupational Health Services [5]. As is stated in the most informal workers have their job. The authors do so book “In the Indian context the coverage of such services is by presenting profiles of no less than 22 informal eco - minimal for the unorganized sector (informal workers) and nomic activities which exist mainly in rural areas. hardly satisfying the expectations of the workers regarding Finally, to support finding medical solutions for access to interventions and protective measures through patients, clinical perspectives are offered for 10 catego - basic occupational health services.” There is a vast inequal - ries of diseases. ity in the practice of prevention of occupational diseases and in the development of healthy workplaces in India. Risks in informal economic activities In the vision of the authors, basic care for workers’ health and occupations should be an integral part of a primary health care. Provi- In 22 chapters the profiles of informal economic activities sion of occupational health care could be prioritized “for and occupations are presented. First the type of activity those in needs and at greatest risk, through the financing is portrayed informing about economic data, regional mechanisms existing for primary health care”. distribution, numbers of workers and employment con- Well-supported primary or community health care can ditions. Next, work processes and working conditions deliver basic care for workers including a significant level are described in detail and information on hygienic of surveillance of the work environment, advises for pre- conditions (toilets, drinking water). Finally, specific ventive measures, education, health surveillance for early work-related and occupational diseases are mentioned, detection of occupational diseases, first aid and return to completed with causative sources at work. References are work support [6, 7]. The WHO The Hague Conference [8] added for additional clinical information presented in the and the common Statement and Pledge of World Organi- final section of the book. zation of Family Doctors (WONCA) and ICOH in Lisbon Such information can support the family physician, in 2014 [9] are cited in the book as signs of a new global nurse or community health worker while identifying the policy. Correspondingly, education and training of pri- cause of a suspected occupational or work-related disease mary care providers is the main objective of this Indian such as in diagnosing asthma, contact eczema, tuberculo- project, sensitizing the professionals on health risks in 22 sis, epicondylitis, depression or bladder cancer. Clearly, informal economic activities and occupations. the risk of missing the right diagnosis is high without The ambitious ultimate target of the project is the basic awareness and information regarding specific risks improvement of health and safety of about 450 mil- at the workplace. lion workers in India. More than 90% of these work in Preventive activities during office hours are encouraged the informal sector, often in poor conditions and con- as well. As an illustration, in the chapter on Agriculture sequently with a high risk of occupational diseases and you can find that almost 300,000 Indian farmers, espe - accidents. Unfortunately, statistics are not easily avail- cially cash crop farmers, committed suicide in the period able. The authors state that hardly any informal worker 1995–2013 caused by fundamental work-related problems. receives professional support in health and safety. Primary health care professionals are stimulated to have an open eye for this risk in contacts with farmers/patients The manual, aim and objectives with depressive mood complaints or anxiety problems. The book, written by a long list of experts, has as a main Information on common risks in a branch can guide pro- aim the education and training of primary care provid- fessionals during a work site visit. So, when visiting a com- ers. Primary health care may contribute to a better health pany in the Leather and tanning industry it is important care for workers, but in practice physicians and staff are to know that chromium exposure can be a risk for getting often not interested in the patients’ occupation, caused lung, skin and nasal cancer. Other chemicals may cause by “a lack of awareness and knowledge about work- bladder or kidney cancer, pancreatic and testicular cancer. related hazards”. In the chapter on Saw mills attention is given to safety A first objective is sensitizing the professionals on the risks and noise, as could be expected, but also to derma- vital relation that exist between work of the patients and titis and respiratory diseases caused by wood dust, fun- their health. In the first two sections of the book con - gal spores and chemicals. In Oil mills workers can be cepts and legislation on occupational health are intro- exposed to extreme heat leading to heat exhaustion and duced, and basic thoughts about hazards and risks, safety heat stroke. No less than 2.5 million Street vendors are van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 3 of 4 working in the city of Mumbai alone. Work characteris- appropriate online sources and Apps. Especially effective tics and related health problems are explicated in the cor- workplace solutions and other preventive measures are responding chapter. missing in this edition. An innovative aspect of the book is the profiling of Readability is important to stimulate the use of the branches and occupations hardly described in the scien- book. In this perspective, information overload can be tific literature. An example is Work in salt pans. In Pub- reduced by deleting detailed information on hospital- Med you can find one scientific article describing work based diagnosis and therapy. Subchapters on not work- processes but no articles on work and health topics. related diseases might not be needed. A needs assessment might be considered to strengthen the orientation of the Clinical perspectives book on primary and community health care. After a generic description, information is given on The inevitability to establish a supportive infrastructure pathogenesis, symptoms, general risk factors, diagnosis, including expert support and referral options for primary tests and treatment. A number of chapters open with care could get more attention, following WHO policies. an adequate introduction on work-related diseases. The Consequently, the number of occupational safety and chapters on Respiratory System Conditions and Skin health experts has to increase rapidly not only to take Health Conditions contain informative subchapters on care for the larger industries, but also to support primary various work-related and occupational diseases. In the health care. chapter on Occupational Neoplastic Disease the reader The capability of primary or community health care to is informed about potential occupational diseases such perform good basic occupational health care as a well- as skin cancer, melanoma, bladder cancer, leukemia, organized, mostly government supported form of care lung cancer and mesothelioma. Interesting paragraphs can be observed in countries such as China, Thailand, on toxic encephalopathy, ‘distress as a result of poverty’, Indonesia and Iran [10–13]. Such investments are some- suicide and depression can be found in the chapter on times motivated by the economic costs of work-related Neurological and Behavioural Conditions. Refreshing is injuries and diseases that vary between 1.8 and 6.0% of the attention for rehabilitation when workers have a cer- Gross Domestic Product (GDP) in country estimates vicobrachial syndrome as can be found in the chapter on [14]. However, one may also argue, citing the words of Musculoskeletal Disorders. the former Secretary General of the United Nations Kofi Surprisingly, common diagnoses in high-income but Annan in 1997, that “health and safety at work is not only increasingly also in lower-income countries such as sound economic policy, it is a basic human right”. adjustment disorders (nervous exhaustion) and burn- out, are not discussed. Similarly only limited attention is Quality of the information given to widespread work-related diseases as chronic low Details can be challenged, surely in a first edition of a back pain and epicondylitis. comprehensive book. As an illustration, in the chapter The authors may consider giving more epidemiologic on bladder cancer no preventive measures can be found data on occupational and work-related diseases (when to reduce industrial exposure, and urine cytology as an available). The presentation of more good practices for instrument for a workers’ health surveillance program the detection, diagnosis and surveillance of occupational can be discussed more in detail, leading to a recommen- and work-related diseases, and for prevention and reha- dation for a health surveillance program. For the next bilitation, could stimulate the realization in primary care. edition, expert referees can screen the text for mistakes and missing parts. Support for a new practice and policy The book has no references per chapter. However, the The publication can play a significant role in supporting reader needs references to verify the validity of the con- primary health care professionals with learning material tent and to know where to find tools or sources for fur - for meetings and courses, contributing to a better quality ther reading. On the other hand, such a comprehensive of health care practice and positive changes for the health book creates a huge amount of quickly outdated ref- of informal workers. erences when not well organized. A solution could be The book is not developed as a ‘how to do’ book with restricting references mainly to recent systematic reviews clear procedures for practice such as on how to per- and evidence-based guidelines. form an occupational history, how to assess occupa- tional asthma, or how to reduce asbestos exposure in Next steps a garage. An idea could be to write a separate ‘practice Next steps are planned. First seminars are hold for family book’ including tailor-made concepts and visualizations physicians focusing on a few informal economic activi- for primary health care, good practices and references to ties. Concrete plans are in development for telecasting van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 4 of 4 References modules to primary care centers, including translated 1. Parekh R, Moti S, editors. Basic Occupational Health Services for informal versions in local language for paramedics and local health industry. Manual for primary care providers. First ed. Mumbai: Indian workers. As the so called “Blind Spot within health care Association of Occupational Health; 2016. Printed books and digital (Kindle) versions can be ordered at http://www.iaohindia.com. Accessed for work” is wide spread, these initiatives are interesting 10 Oct 2016. for other countries [15]. The use of modern online and 2. World Health Assembly Resolution on Universal Health Coverage 58.33. blended education and information technics is envisaged 2005. http://www.who.int/health_financing/documents/cov-wharesolu- tion5833/en/. Accessed 10 Oct 2016. in the book. This part might be elaborated in the future. 3. International Labor Organization (Geneva), United Nations agency deal- What about massive open online courses (MOOCs), and ing with work and labor relations. http://www.ilo.org/global/lang–en/ the application of apps for professionals, workers and index.htm. Accessed 10 Oct 2016. 4. International Commission on Occupational Health, leading international companies [16, 17], YouTube videos and ‘serious games’? non-governmental professional society. http://www.icohweb.org/site/ Of course adequate funding is needed. homepage.asp. Accessed 10 Oct 2016. 5. Rantanen J, Lehtinen S, Iavicoli S. Occupational health services in selected International Commission on Occupational Health (ICOH) member coun- International collaboration tries. Scand J Work Environ Health. 2013;39:212–6. This inspiring book from India invites us to intensify 6. Van Dijk F, Buijs P. Primary care and workers’ health. Summary report of our national efforts and the international collaboration a special session at the ICOH International Congress in Seoul, Korea, June 2015. ICOH Newslett. 2016; 14 (April): 14–16. http://www.icohweb. that is still in the earliest phase. International agencies org/site/multimedia/newsletter/pdf/icoh_newsletter_vol13_no1.pdf. could collaborate more intensively and effectively. Long- Accessed 10 Oct 2016. term funding is essential to make significant progress as 7. Buijs P, van Dijk F. Essential interventions on Workers’ Health by Primary Health Care. A scoping review of the literature: a technical report. Hoofd- a number of national initiatives are waiting for support, dorp: TNO Healthy Living; 2014. (Report; 10755). http://publications.tno. evaluation, sharing and up scaling. nl/publication/34610495/8CgREU/buijs-2014-essential.pdf. 8. WHO, The Hague Conference (2011): Connecting health and labour: What role for ocupational health in primary health care?. http://www.who.int/ Conclusions occupational_health/publications/the-hague-summary-040512-A4web. This book from India aims at informing and educating pdf. Accessed 10 Oct 2016. primary health care professionals about working condi- 9. WONCA—ICOH statement on workers and their families; Lisbon, Portugal, July 2014 [Internet] WONCA; Global Family Doctor. 2014 [cited tions of informal workers and related occupational and 2015 Nov 26]. http://www.globalfamilydoctor.com/News/WONCAandI- work-related diseases. Recognition, diagnosis, treatment COHstatementonworkersandtheirfamilies.aspx. Accessed 10 Oct 2016. and prevention can be improved in daily practice. The 10. Chen Y, Chen J, Sun Y, Liu Y, Wu L, Wang Y, Yu S. Basic Occupational Health Services in Baoan, China. J Occup Health. 2010;52:82–8. initiative fits well in worldwide developments in which 11. Kaewboonchoo O, Silpasuwan P, Jirapongsuwan A, Rawiworrakul T, educated and supported primary health care is test- Hansing S. Participatory capacity building in occupational disease surveil- ing and integrating new basic forms of workers’ health lance among primary care unit health personnel. Southeast Asian J Trop Med Public Health. 2011;42:1262–8. care, “to the benefit of all workers and their families” 12. Denny HM. Impact of occupational health interventions in Indonesia. (WONCA-ICOH Pledge) [9]. Thesis. University of South Florida. 2012. http://scholarcommons.usf.edu/ etd/4308/. Accessed 10 Oct 2016. Authors’ contributions 13. Rafiei M, Ezzatian R, Farshad A, Sokooti M, Tabibi R, Colosio C. Occupa- FvD developed the concept and design of the study and has drafted the tional Health Services Integrated in Primary Health Care in Iran. Ann Glob first manuscript version. FvD and PB both studied international background Health. 2015;81:561–7. literature and practice. Both authors analyzed the book content. Both authors 14. Takala J, Hämäläinen P, Saarela KL, Yun LY, Manickam K, Jin TW, Heng P, revised draft texts. Both authors read and approved the final manuscript. Tjong C, Kheng LG, Lim S, Lin GS. Global estimates of the burden of injury and illness at work. J Occup Environ Hyg. 2012;11:326–37. Author details 15. Buijs PC, Gunneyon B, van Weel C. Primary health care: what role for Learning and Developing Occupational Health (LDOH) Foundation, occupational health? Br J Gen Pract. 2012;62:623–4. Speelkamp 28, 3831, PE, Leusden, The Netherlands. Department of Public 16. ILO ergonomic checkpoints apps. http://www.ilo.org/safework/info/pub- and Occupational Health, EMGO+ Institute for Health and Care Research, VU lications/WCMS_438082/lang–en/index.htm. Accessed 10 Oct 2016. University Medical Center Amsterdam, Amsterdam, The Netherlands. 17. Dokterhoe website and app for health workers (Dutch language). https:// www.dokterhoe.nl/. Accessed 10 Oct 2016. Acknowledgements Not applicable. Competing interests The authors declare that they have no competing interests. Received: 17 October 2016 Accepted: 12 January 2017 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Asia Pacific Family Medicine Springer Journals

Manual for primary health care on Basic Occupational Health Services. Encouraging publication from India, focused on informal occupations

Asia Pacific Family Medicine , Volume 16 (1) – Jan 19, 2017

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Medicine & Public Health; General Practice / Family Medicine; Primary Care Medicine
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Abstract

Objective: To discuss a new book from India intended to inform and educate primary health care professionals on workers’ health problems, with the aim to encourage new initiatives. Study design: The book is considered against the background of international developments and evaluated on the usefulness for practice and policy development. Results: The publication focuses on the 90% of the workers in India working informal, without a contract or social security, and often exposed to poor working conditions. It is the final aim of the book to prioritize care for those at the highest risk. For informal workers specialized occupational health services are absent. Therefore, primary health care might take care of basic facilities on workers’ health, when educated and adequately supported by online information, occupational health experts and clinical referral services. Such new developments started as well in other countries such as China, Thailand, Iran and Indonesia, encouraged by WHO, WONCA (family physicians), ILO and ICOH (occu- pational health experts). In the book working conditions are described in 22 branches of economic activities in India with many informal workers like agriculture, leather and tanning industry, oil mills and street vendors. Next, associ- ated health complaints and occupational diseases are explained. This information is relevant for family physicians to be able to recognize work-relatedness of health complaints and diseases. Numerous diseases can be work related such as asthma, depressive disorders, dermatitis, a variety of musculoskeletal disorders, hearing impairment, cancer of many organs, various infectious and neurological diseases. Diagnosis, treatment and prevention can be improved in primary health care, as well as advising in return to work activities. More detailed information on specific occupational or work-related diseases is given in clinical chapters. Comments are given to improve the usefulness in supporting new practices and policies. Conclusion: This book from India fits well in worldwide developments promoting the integration of forms of work - ers’ health care in primary health care. Keywords: Primary health care, Family physician, Community health care, Occupational health, Workers’ health, Informal worker, Occupational diseases, Prevention, Return to work Background Indian Association of Occupational Health published a Like many other countries, India has a serious occupa- book (391 pages) on Basic Occupational Health Services tional health service coverage problem. Therefore, the for the informal Industry [1]. The book and associated pro - ject can be appreciated within the WHO strategy of Uni- versal Health Coverage, focusing on workers’ health [2]. *Correspondence: v.dijk.workandhealth@gmail.com Learning and Developing Occupational Health (LDOH) Foundation, The Basic Occupational Health Services (BOHS) strategy Speelkamp 28, 3831, PE, Leusden, The Netherlands of World Health Organization (WHO), International Labor Full list of author information is available at the end of the article © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 2 of 4 Organization (ILO) [3] and  International Commission on principles and health surveillance. Instruments such as Occupational Health (ICOH) [4] is the chosen fundament occupational history taking, occupational hygiene tools of the project. Primary health care is considered as a first and monitoring are shortly described. level of “workers’ health care” for the about 85% of 3.1 bil- A second objective is to inform primary health care lion workers worldwide who are not supported by expert- about a wide range of concrete risks at workplaces where based Occupational Health Services [5]. As is stated in the most informal workers have their job. The authors do so book “In the Indian context the coverage of such services is by presenting profiles of no less than 22 informal eco - minimal for the unorganized sector (informal workers) and nomic activities which exist mainly in rural areas. hardly satisfying the expectations of the workers regarding Finally, to support finding medical solutions for access to interventions and protective measures through patients, clinical perspectives are offered for 10 catego - basic occupational health services.” There is a vast inequal - ries of diseases. ity in the practice of prevention of occupational diseases and in the development of healthy workplaces in India. Risks in informal economic activities In the vision of the authors, basic care for workers’ health and occupations should be an integral part of a primary health care. Provi- In 22 chapters the profiles of informal economic activities sion of occupational health care could be prioritized “for and occupations are presented. First the type of activity those in needs and at greatest risk, through the financing is portrayed informing about economic data, regional mechanisms existing for primary health care”. distribution, numbers of workers and employment con- Well-supported primary or community health care can ditions. Next, work processes and working conditions deliver basic care for workers including a significant level are described in detail and information on hygienic of surveillance of the work environment, advises for pre- conditions (toilets, drinking water). Finally, specific ventive measures, education, health surveillance for early work-related and occupational diseases are mentioned, detection of occupational diseases, first aid and return to completed with causative sources at work. References are work support [6, 7]. The WHO The Hague Conference [8] added for additional clinical information presented in the and the common Statement and Pledge of World Organi- final section of the book. zation of Family Doctors (WONCA) and ICOH in Lisbon Such information can support the family physician, in 2014 [9] are cited in the book as signs of a new global nurse or community health worker while identifying the policy. Correspondingly, education and training of pri- cause of a suspected occupational or work-related disease mary care providers is the main objective of this Indian such as in diagnosing asthma, contact eczema, tuberculo- project, sensitizing the professionals on health risks in 22 sis, epicondylitis, depression or bladder cancer. Clearly, informal economic activities and occupations. the risk of missing the right diagnosis is high without The ambitious ultimate target of the project is the basic awareness and information regarding specific risks improvement of health and safety of about 450 mil- at the workplace. lion workers in India. More than 90% of these work in Preventive activities during office hours are encouraged the informal sector, often in poor conditions and con- as well. As an illustration, in the chapter on Agriculture sequently with a high risk of occupational diseases and you can find that almost 300,000 Indian farmers, espe - accidents. Unfortunately, statistics are not easily avail- cially cash crop farmers, committed suicide in the period able. The authors state that hardly any informal worker 1995–2013 caused by fundamental work-related problems. receives professional support in health and safety. Primary health care professionals are stimulated to have an open eye for this risk in contacts with farmers/patients The manual, aim and objectives with depressive mood complaints or anxiety problems. The book, written by a long list of experts, has as a main Information on common risks in a branch can guide pro- aim the education and training of primary care provid- fessionals during a work site visit. So, when visiting a com- ers. Primary health care may contribute to a better health pany in the Leather and tanning industry it is important care for workers, but in practice physicians and staff are to know that chromium exposure can be a risk for getting often not interested in the patients’ occupation, caused lung, skin and nasal cancer. Other chemicals may cause by “a lack of awareness and knowledge about work- bladder or kidney cancer, pancreatic and testicular cancer. related hazards”. In the chapter on Saw mills attention is given to safety A first objective is sensitizing the professionals on the risks and noise, as could be expected, but also to derma- vital relation that exist between work of the patients and titis and respiratory diseases caused by wood dust, fun- their health. In the first two sections of the book con - gal spores and chemicals. In Oil mills workers can be cepts and legislation on occupational health are intro- exposed to extreme heat leading to heat exhaustion and duced, and basic thoughts about hazards and risks, safety heat stroke. No less than 2.5 million Street vendors are van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 3 of 4 working in the city of Mumbai alone. Work characteris- appropriate online sources and Apps. Especially effective tics and related health problems are explicated in the cor- workplace solutions and other preventive measures are responding chapter. missing in this edition. An innovative aspect of the book is the profiling of Readability is important to stimulate the use of the branches and occupations hardly described in the scien- book. In this perspective, information overload can be tific literature. An example is Work in salt pans. In Pub- reduced by deleting detailed information on hospital- Med you can find one scientific article describing work based diagnosis and therapy. Subchapters on not work- processes but no articles on work and health topics. related diseases might not be needed. A needs assessment might be considered to strengthen the orientation of the Clinical perspectives book on primary and community health care. After a generic description, information is given on The inevitability to establish a supportive infrastructure pathogenesis, symptoms, general risk factors, diagnosis, including expert support and referral options for primary tests and treatment. A number of chapters open with care could get more attention, following WHO policies. an adequate introduction on work-related diseases. The Consequently, the number of occupational safety and chapters on Respiratory System Conditions and Skin health experts has to increase rapidly not only to take Health Conditions contain informative subchapters on care for the larger industries, but also to support primary various work-related and occupational diseases. In the health care. chapter on Occupational Neoplastic Disease the reader The capability of primary or community health care to is informed about potential occupational diseases such perform good basic occupational health care as a well- as skin cancer, melanoma, bladder cancer, leukemia, organized, mostly government supported form of care lung cancer and mesothelioma. Interesting paragraphs can be observed in countries such as China, Thailand, on toxic encephalopathy, ‘distress as a result of poverty’, Indonesia and Iran [10–13]. Such investments are some- suicide and depression can be found in the chapter on times motivated by the economic costs of work-related Neurological and Behavioural Conditions. Refreshing is injuries and diseases that vary between 1.8 and 6.0% of the attention for rehabilitation when workers have a cer- Gross Domestic Product (GDP) in country estimates vicobrachial syndrome as can be found in the chapter on [14]. However, one may also argue, citing the words of Musculoskeletal Disorders. the former Secretary General of the United Nations Kofi Surprisingly, common diagnoses in high-income but Annan in 1997, that “health and safety at work is not only increasingly also in lower-income countries such as sound economic policy, it is a basic human right”. adjustment disorders (nervous exhaustion) and burn- out, are not discussed. Similarly only limited attention is Quality of the information given to widespread work-related diseases as chronic low Details can be challenged, surely in a first edition of a back pain and epicondylitis. comprehensive book. As an illustration, in the chapter The authors may consider giving more epidemiologic on bladder cancer no preventive measures can be found data on occupational and work-related diseases (when to reduce industrial exposure, and urine cytology as an available). The presentation of more good practices for instrument for a workers’ health surveillance program the detection, diagnosis and surveillance of occupational can be discussed more in detail, leading to a recommen- and work-related diseases, and for prevention and reha- dation for a health surveillance program. For the next bilitation, could stimulate the realization in primary care. edition, expert referees can screen the text for mistakes and missing parts. Support for a new practice and policy The book has no references per chapter. However, the The publication can play a significant role in supporting reader needs references to verify the validity of the con- primary health care professionals with learning material tent and to know where to find tools or sources for fur - for meetings and courses, contributing to a better quality ther reading. On the other hand, such a comprehensive of health care practice and positive changes for the health book creates a huge amount of quickly outdated ref- of informal workers. erences when not well organized. A solution could be The book is not developed as a ‘how to do’ book with restricting references mainly to recent systematic reviews clear procedures for practice such as on how to per- and evidence-based guidelines. form an occupational history, how to assess occupa- tional asthma, or how to reduce asbestos exposure in Next steps a garage. An idea could be to write a separate ‘practice Next steps are planned. First seminars are hold for family book’ including tailor-made concepts and visualizations physicians focusing on a few informal economic activi- for primary health care, good practices and references to ties. Concrete plans are in development for telecasting van Dijk and Buijs Asia Pac Fam Med (2017) 16:2 Page 4 of 4 References modules to primary care centers, including translated 1. Parekh R, Moti S, editors. Basic Occupational Health Services for informal versions in local language for paramedics and local health industry. Manual for primary care providers. First ed. Mumbai: Indian workers. As the so called “Blind Spot within health care Association of Occupational Health; 2016. Printed books and digital (Kindle) versions can be ordered at http://www.iaohindia.com. Accessed for work” is wide spread, these initiatives are interesting 10 Oct 2016. for other countries [15]. The use of modern online and 2. World Health Assembly Resolution on Universal Health Coverage 58.33. blended education and information technics is envisaged 2005. http://www.who.int/health_financing/documents/cov-wharesolu- tion5833/en/. Accessed 10 Oct 2016. in the book. This part might be elaborated in the future. 3. International Labor Organization (Geneva), United Nations agency deal- What about massive open online courses (MOOCs), and ing with work and labor relations. http://www.ilo.org/global/lang–en/ the application of apps for professionals, workers and index.htm. Accessed 10 Oct 2016. 4. International Commission on Occupational Health, leading international companies [16, 17], YouTube videos and ‘serious games’? non-governmental professional society. http://www.icohweb.org/site/ Of course adequate funding is needed. homepage.asp. Accessed 10 Oct 2016. 5. Rantanen J, Lehtinen S, Iavicoli S. Occupational health services in selected International Commission on Occupational Health (ICOH) member coun- International collaboration tries. Scand J Work Environ Health. 2013;39:212–6. This inspiring book from India invites us to intensify 6. Van Dijk F, Buijs P. Primary care and workers’ health. Summary report of our national efforts and the international collaboration a special session at the ICOH International Congress in Seoul, Korea, June 2015. ICOH Newslett. 2016; 14 (April): 14–16. http://www.icohweb. that is still in the earliest phase. International agencies org/site/multimedia/newsletter/pdf/icoh_newsletter_vol13_no1.pdf. could collaborate more intensively and effectively. Long- Accessed 10 Oct 2016. term funding is essential to make significant progress as 7. Buijs P, van Dijk F. Essential interventions on Workers’ Health by Primary Health Care. A scoping review of the literature: a technical report. Hoofd- a number of national initiatives are waiting for support, dorp: TNO Healthy Living; 2014. (Report; 10755). http://publications.tno. evaluation, sharing and up scaling. nl/publication/34610495/8CgREU/buijs-2014-essential.pdf. 8. WHO, The Hague Conference (2011): Connecting health and labour: What role for ocupational health in primary health care?. http://www.who.int/ Conclusions occupational_health/publications/the-hague-summary-040512-A4web. This book from India aims at informing and educating pdf. Accessed 10 Oct 2016. primary health care professionals about working condi- 9. WONCA—ICOH statement on workers and their families; Lisbon, Portugal, July 2014 [Internet] WONCA; Global Family Doctor. 2014 [cited tions of informal workers and related occupational and 2015 Nov 26]. http://www.globalfamilydoctor.com/News/WONCAandI- work-related diseases. Recognition, diagnosis, treatment COHstatementonworkersandtheirfamilies.aspx. Accessed 10 Oct 2016. and prevention can be improved in daily practice. The 10. Chen Y, Chen J, Sun Y, Liu Y, Wu L, Wang Y, Yu S. Basic Occupational Health Services in Baoan, China. J Occup Health. 2010;52:82–8. initiative fits well in worldwide developments in which 11. Kaewboonchoo O, Silpasuwan P, Jirapongsuwan A, Rawiworrakul T, educated and supported primary health care is test- Hansing S. Participatory capacity building in occupational disease surveil- ing and integrating new basic forms of workers’ health lance among primary care unit health personnel. Southeast Asian J Trop Med Public Health. 2011;42:1262–8. care, “to the benefit of all workers and their families” 12. Denny HM. Impact of occupational health interventions in Indonesia. (WONCA-ICOH Pledge) [9]. Thesis. University of South Florida. 2012. http://scholarcommons.usf.edu/ etd/4308/. Accessed 10 Oct 2016. Authors’ contributions 13. Rafiei M, Ezzatian R, Farshad A, Sokooti M, Tabibi R, Colosio C. Occupa- FvD developed the concept and design of the study and has drafted the tional Health Services Integrated in Primary Health Care in Iran. Ann Glob first manuscript version. FvD and PB both studied international background Health. 2015;81:561–7. literature and practice. Both authors analyzed the book content. Both authors 14. Takala J, Hämäläinen P, Saarela KL, Yun LY, Manickam K, Jin TW, Heng P, revised draft texts. Both authors read and approved the final manuscript. Tjong C, Kheng LG, Lim S, Lin GS. Global estimates of the burden of injury and illness at work. J Occup Environ Hyg. 2012;11:326–37. Author details 15. Buijs PC, Gunneyon B, van Weel C. Primary health care: what role for Learning and Developing Occupational Health (LDOH) Foundation, occupational health? Br J Gen Pract. 2012;62:623–4. Speelkamp 28, 3831, PE, Leusden, The Netherlands. Department of Public 16. ILO ergonomic checkpoints apps. http://www.ilo.org/safework/info/pub- and Occupational Health, EMGO+ Institute for Health and Care Research, VU lications/WCMS_438082/lang–en/index.htm. Accessed 10 Oct 2016. University Medical Center Amsterdam, Amsterdam, The Netherlands. 17. Dokterhoe website and app for health workers (Dutch language). https:// www.dokterhoe.nl/. Accessed 10 Oct 2016. Acknowledgements Not applicable. Competing interests The authors declare that they have no competing interests. Received: 17 October 2016 Accepted: 12 January 2017

Journal

Asia Pacific Family MedicineSpringer Journals

Published: Jan 19, 2017

References