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La Medicina Del Lavoro Apr 2024Generative artificial intelligence and Large Language Models are reshaping labor dynamics and occupational health practices. As AI continues to evolve, there's a...
Generative artificial intelligence and Large Language Models are reshaping labor dynamics and occupational health practices. As AI continues to evolve, there's a critical need to customize ethical considerations for its specific impacts on occupational health. Recognizing potential ethical challenges and dilemmas, stakeholders and physicians are urged to proactively adjust the practice of occupational medicine in response to shifting ethical paradigms. By advocating for a comprehensive review of the International Commission on Occupational Health ICOH code of Ethics, we can ensure responsible medical AI deployment, safeguarding the well-being of workers amidst the transformative effects of automation in healthcare.
Topics: Artificial Intelligence; Occupational Medicine; Humans; Codes of Ethics; Occupational Health
PubMed: 38686573
DOI: 10.23749/mdl.v115i2.15881 -
Arhiv Za Higijenu Rada I Toksikologiju Mar 2015
Topics: Occupational Medicine; Risk Assessment; Stress, Psychological; Workplace
PubMed: 25816309
DOI: 10.1515/aiht-2015-66-2629 -
Annali Di Igiene : Medicina Preventiva... 2017To practice occupational health in Europe, a medical doctor must qualify in occupational medicine. This requires a period of postgraduate specialist medical training...
BACKGROUND
To practice occupational health in Europe, a medical doctor must qualify in occupational medicine. This requires a period of postgraduate specialist medical training lasting a minimum of four years, in conformity with European regulations, to obtain a certificate of completion of training which is then mutually recognized within the entire European Union.
DISCUSSION
In 2002 an Italian law allowed doctors specialized in public health medicine and legal/forensic medicine to also practice as consultants in occupational medicine in the country. However a subsequent law in 2008 determined that only physicians specialized in occupational medicine could freely practice as consultants in this discipline. The other two categories (consultants in public health medicine and consultants in legal/forensic medicine) were required to undertake additional training (a Master course) to qualify as consultants in occupational medicine.
CONCLUSIONS
Doctors who entered postgraduate training in public health or legal/forensic medicine before 2008, with the option to practice also as consultants in occupational medicine upon completion of their training, suffered an unprecedented and legally questionable retroactive application of this new law which stripped them of previously acquired rights. Moreover, even after qualifying by undertaking this extra training in occupational medicine, the latter two categories of doctors do not have their training recognized in other member states of the European Union. To disallow the rights of doctors qualified in occupational medicine to work as consultants in the latter medical discipline elsewhere within the European Union seems a clear violation of professional rights and, as such, legal action could be taken to submit this issue to European attention.
Topics: Certification; European Union; Italy; Occupational Medicine
PubMed: 28383611
DOI: 10.7416/ai.2017.2147 -
Journal of Occupational Health May 2005Slovenia is a small, fast developing country in the EU with approximately 2,000,000 inhabitants and 700,000 employed. Occupational medicine has been present in Slovenia... (Review)
Review
Slovenia is a small, fast developing country in the EU with approximately 2,000,000 inhabitants and 700,000 employed. Occupational medicine has been present in Slovenia for as long as 500 yr. Today, 130 specialists of occupational medicine are in charge of health protection of the employed (including transport workers and athletes). There are also 1,100 safety engineers, who take care of the technical side of occupational safety. We are guided in our work by modern occupational health and safety legislation, which is based on EU directive 89/391EEC. The average sick leave rate in Slovenia is about 4.7%, caused mostly by injuries, bone, muscle and connective tissue diseases and respiratory diseases. Sick leave appears most frequently in the textile industries and coal mining. Annually, around 26,000 occupational injuries (32.7 per 1,000 employed) and 25 fatalities (3 per 100,000 employed) occur. Most injuries occur in construction, manufacturing and farming. Each year there are 8,500 disablility cases (2,500 disability retirements-most caused by mental illnesses), but only 30 acknowledged cases of occupational diseases (mostly occupational skin diseases, asthma and asbestosis). Occupational medicine in Slovenia is strongly associated with occupational medicine in the more developed European countries. It is therefore moving out of clinics and into the working environment, where its goals lie in primary prevention, i.e. establishing and keeping healthy working environments that guarantee high productivity, health and well-being of workers as a whole.
Topics: Adolescent; Adult; Female; Humans; Male; Middle Aged; Occupational Medicine; Slovenia
PubMed: 15953840
DOI: 10.1539/joh.47.193 -
Pain Physician 2008Today, with the growing interest of the medical community and others in practice guidelines, there is greater emphasis on formal procedures and methods for arriving at a... (Review)
Review
A critical appraisal of 2007 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Interventional Pain Management: an independent review utilizing AGREE, AMA, IOM, and other criteria.
BACKGROUND
Today, with the growing interest of the medical community and others in practice guidelines, there is greater emphasis on formal procedures and methods for arriving at a widely scrutinized and endorsed consensus than ever before. Conflicts in terminology and technique are notable for the confusion that guidelines create and for what they reflect about differences in values, experiences, and interests among different parties. While public and private development activities continue to multiply, the means for coordinating these efforts to resolve inconsistencies, fill in gaps, track applications and results, and assess the soundness of particular guidelines continue to be limited. In this era of widespread guideline development by private organizations, the American College of Occupational and Environment Medicine (ACOEM) has developed guidelines that evaluate areas of clinical practice well beyond the scope of occupational medicine and yet fail to properly involve physicians expert in these, especially those in the field of interventional pain management. As the field of guidelines suffers from imperfect and incomplete scientific knowledge as well as imperfect and uneven means of applying that knowledge without a single or correct way to develop guidelines, ACOEM guidelines have been alleged to hinder patient care, reduce access to interventional pain management procedures, and transfer patients into a system of disability, Medicare, and Medicaid.
OBJECTIVE
To critically appraise occupational medicine practice guidelines for interventional pain management by an independent review utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE), American Medical Association (AMA), Institute of Medicine (IOM), and other commonly utilized criteria.
METHODS
Revised chapters of ACOEM guidelines, low back pain and chronic pain, developed in 2007 and 2008 are evaluated, utilizing AGREE, AMA, IOM instruments, and Shaneyfelt et al's criteria, were independently reviewed by 4 appraisers.
RESULTS
Critical appraisal utilizing the AGREE instrument found that both chapters scored less than 10% in 3 of the 6 domains, less than 20% in one domain, over 30% in one domain, and over 70% in one domain. Global assessment also scored below 30% with a recommendation from AGREE, "not recommended or suitable for use in practice." Based on AMA key attributes, both chapters of ACOEM guidelines met only one of the 6 key attributes, only 3 of the 8 attributes were met by IOM criteria, and based on the criteria described by Shaneyfelt et al, overall only 28% of criteria were met.
CONCLUSION
Both the low back pain and chronic pain chapters of the ACOEM guidelines may not be ideal for clinical use based on the assessment by the AGREE instrument, AMA attributes, and criteria established by Shaneyfelt et al. They also scored low on IOM criteria (37.5%). These guidelines may not be applicable for clinical use.
Topics: American Medical Association; Databases, Bibliographic; Environmental Medicine; Evidence-Based Medicine; Humans; Occupational Medicine; Pain Management; Practice Guidelines as Topic; Quality Assurance, Health Care; United States
PubMed: 18523501
DOI: No ID Found -
Postgraduate Medical Journal Feb 1989
Topics: Humans; Occupational Health Services; Occupational Medicine
PubMed: 2780464
DOI: 10.1136/pgmj.65.760.65 -
La Medicina Del Lavoro Feb 2017The entire Italian University system, including the whole field of medical teaching and research, is currently passing through a period of cumbersome changes due to the...
The entire Italian University system, including the whole field of medical teaching and research, is currently passing through a period of cumbersome changes due to the many difficulties encountered in its reform process. Academic occupational medicine is deeply involved in this process that resembles a real crisis. Given this background, this contribution - written as President of the Italian College of Occupational Medicine Full Professors - has the main objective to open a debate about the current generalized crisis of our Academic Discipline and about its possible future developments. Questions that appear most relevant to the nearly forty University Institutes we are working in include: The constantly decreasing number of professors and researchers (presently about 20 full professors, 50 associate professors and 60 researchers); the reduced ability to recruit young researchers; the contraction of resources and funds; the difficult coordination with other clinical and prevention disciplines in teaching activities. Despite this, points of scientific and professional excellence in many fields exist in our Institutes: from toxicology and epidemiology, to respiratory diseases and ergonomics, to evidence based prevention and quality systems promotion. The expected debate should facilitate new organizational links within and across Universities in order to gain critical masses, improve capabilities in new fields of research (as dose and effect indicators and their matrices, epigenetics, exposomics, connection of exposure data with epidemiological evidences), innovate and expand teaching (in Medical Schools courses and in Residency programs), and advance clinical-diagnostic practices in University Hospitals.
Topics: Academies and Institutes; Forecasting; Italy; Occupational Medicine; Research
PubMed: 28240728
DOI: 10.23749/mdl.v108i1.5994 -
Occupational and Environmental Medicine May 1997To investigate the views of specialists in occupational medicine about business ethics in occupational medicine. (Review)
Review
OBJECTIVE
To investigate the views of specialists in occupational medicine about business ethics in occupational medicine.
METHOD
A qualitative study with face to face focus groups and successive reviews of the draft consensus was undertaken of all accredited specialists in occupational medicine who were members of the south Wales and west of England group of the Society of Occupational Medicine, and of all regional specialty advisers and deputies from the Faculty of Occupational Medicine.
RESULTS
There was widespread agreement for the need of a code of business ethics. In all, during the four draft stages of preparing a consensus, 72% (28/39) of members of the south Wales and west of England group of the Society of Occupational Medicine, and 31% (20/64) of regional specialty advisers and deputies provided detailed comment for inclusion in it.
CONCLUSIONS
Consensus of their views was reached among study participants for issues of business ethics involving advertising, competence, qualifications, fees, commitment, changes in provider contracts, regulation, and supervision of trainees. It provides a basis for further debate.
Topics: Accreditation; Advertising; Certification; Confidentiality; Education, Medical, Graduate; Ethics, Professional; Fees and Charges; Humans; Medical Records; Occupational Health Services; Occupational Medicine; United Kingdom
PubMed: 9196458
DOI: 10.1136/oem.54.5.351 -
International Journal of Environmental... Mar 2020Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to...
Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer.
Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician's role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.
Topics: European Union; Humans; Neoplasms; Occupational Diseases; Occupational Medicine; Workplace
PubMed: 32231054
DOI: 10.3390/ijerph17072279 -
International Maritime Health 2019This paper describes the methodological aspects of calculation of incidence rates from incomplete datain occupational epidemiology. Proportionate measures in... (Review)
Review
This paper describes the methodological aspects of calculation of incidence rates from incomplete datain occupational epidemiology. Proportionate measures in epidemiological studies are useful e.g. to describethe proportion of slips, trips and falls compared to other types of injury mechanisms within singleage-strata. However, a comparison of proportions of slips, trips and falls among the different age-stratagives no meaning and can hamper the conclusions. Examples of a constructed example and some selectedstudies show how estimates of incidence rates can be calculated from the proportionate data by applyingestimates of denominators available from other information. The calculated examples show how the risksbased on the incidence rates in some cases differ from the risks based on the proportionate rates withthe consequence of hampering the conclusions and the recommendations for prevention. In some casesthe proportionate rates give good estimates of the incidence rates, but in other studies this might causeerrors. It is recommended that estimates of the incidence rates should be used, where this is possible, byestimation of the size of the population. The paper is intended to be useful for students and teachers inepidemiology by using the attached Excel training file.
Topics: Accidental Falls; Accidents, Occupational; Age Factors; Epidemiologic Methods; Humans; Incidence; Naval Medicine; Occupational Medicine
PubMed: 31617934
DOI: 10.5603/IMH.2019.0029