Theory and Practice of Health Surveillance in the Workplace - Coursework Example

?Running head: INTRODUCTION OF THEORY AND PRACTICE OF HEALTH SURVEILLANCE IN THE WORKPLACE Introduction of Theory and Practice of Health Surveillancein the Workplace Insert Name Insert Course Title Insert Instructor’s Name 22 September 2011 Outline Introduction Health Surveillance in the Workplace Purpose of workforce health surveillance Types of health surveillance Evidence-based analysis of health surveillance issue: occupational Asthma Legal requirements for conducting health surveillance Role of occupational health in responding to surveillance findings Communicating surveillance results to employees and managers Quality assurance systems and processes Conclusion References Introduction of Theory and Practice of Health Surveillance in the Workplace Introduction The delight of many people in finding employment is to work and operate in a safe workplace environment that also gives assurance of good health. However, evidence from modern workplace environments will confirm that there exist numerous health and safety issues at workplace (Lewis and Thornbory, 2010). The presence of these varied health and safety issues cannot guarantee workers and all other persons involved meaningful occupation environment hence it is always important to ensure the identified issues are dealt with. In an attempt to ensure there is promotion of adequate health and safety of individuals in the workplace, risk assessment has become one way of identifying the pertinent problems and issues compounding the workplace (Lewis and Thornbory 2010). The essence of risk assessment is to identify the risks present and subsequently create a safe system in the workplace. What should be known is that, in most cases health, safety risks present in the working environment are not seen or felt, and therefore, demonstrable signs may be absent. As a result, the effects may remain hidden only to surface after a particular period. The evolution of health surveillance in the workplace has been gradual but impacting and it is from this interest that effort will be made to conduct evidence-based analysis of health surveillance practice in the workplace. The focus of the paper will center on; discussion and exploration of nature and purpose of workforce surveillance, legal requirements for conducting health surveillance, types of health surveillance and also evidence-based analysis of health surveillance to particular occupational exposure. Throughout this, the role of occupational health in responding to abnormal findings will be evaluated and how well they can be communicated to employees and managers, and discussion on the quality assurance systems and processes used for surveillance will be assessed. Health Surveillance in the Workplace Profound changes are taking place at the workplace in many countries and industries and the nature of changes can be evidenced in the increasing change in work, work environments, and employment patterns (Lilley and Feyer, 2010). All these aspects are seen to be shaped and influenced by the increasing political, economic, technological, and social change that characterizes the modern societies (Lilley and Feyer 2010). Emergence of these new profiles of hazards is negatively impacting the health and safety of workers, a concern that calls for appropriate actions of mitigation. The overall measure has been a call, sometimes a legal call for employers to initiate programs and measures that should promote the health and safety of its employees. Both international and national bodies have been formulated as guidance frameworks that propagate for enhancement of a health and safer working environment for workers. International Labor Organization (ILO) has in place, Occupational Safety and Health Convection number 155 and the Occupational Health Service Convection number 161, in which employers in both convections are required to ensure health and safety needs of workers are promoted (Stellman and International Labour Office 1998). In this way, employers through appropriate programs are supposed to promote the health of workers, improve the general working conditions and the working environment, without forgetting to maintain the health of the overall enterprise (Stellman and International Labour Office, 1998). The expression by ILO is that working environment for all need to be premised on health principles whereby the quality of the working environment should be achieved through compliance to numerous safety and health standards. To achieve this goal, surveillance of health conditions in the enterprise becomes necessary with aim of generating information for decision-making and action purposes (Stellman and International Labour Office, 1998). Surveillance is term that possesses wide usage in different forum and subjects. As the Centers for Disease Control and Prevention (2009) would express, usage of the term in health perspective would mean, “an ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation and evaluation of public health practice, usually integrated with timely feedback of the data to those who need to know” (Healey and Walker, 2009, p.31). Given the above definition, surveillance involves numerous activities, which are related and dependent on each other. In this sphere, health surveillance can be sieved within the parameters of health issues in any given environment and be regarded as the process which involves, “data collection for infectious and chronic diseases, injuries, environmental and occupational exposures and personal behaviors that promote health and prevent disease” (Rubertone and Brundage, 2002). Generally, wide array of techniques are normally used in this exercise and the nature of techniques used are not disease specific but application is always to gather data concerning variety of health conditions, exposures and related behaviors that revolves around public health. In all these endeavors, health surveillance rest on assumption that understanding a problem constitute a solid and basic ground in solving the problem (Healey and Walker, 2009). ILO has established the scope in which the surveillance of the working environment takes place. The most prevalent areas surveillance covers include: identifying and evaluating the environmental factors which affect or may affect the health of the worker; and undertaking assessment of conditions of occupational hygiene and factors in organization of work that pose risk to worker health (Stellman and International Labour Office, 1998). In addition, the scope may include carrying out assessment of collective and personal protective equipment, assessment of the monitoring methods, and assessment of control systems that in most cases are designed to eliminate or reduce exposure (Stellman and International Labour Office, 1998). In carrying out health surveillance, monitoring becomes part of the process whereby risks and their outcomes are monitored. In situations exposure to risks become excessive, concerted efforts are made to control them despite of the eventual results and workers affected need to be evaluated (Stellman and International Labour Office, 1998). When health surveillance has been undertaken, it is always necessary to create a hazardous inventory in which there is identification of risks that pose threat to health of the workers and how such risks can be controlled through adoption of specific measures. In conclusion, it can be stated that surveillance of the workplace environment is usually undertaken with aim to generate information concerning occupational health needs of the organization, which also provide room to prioritize the needs for preventive and control actions. More so, carrying out health surveillance should precede the initial process of initiating services in the organization that aim to ensure health needs of workers are observed. Purpose of workforce health surveillance The purpose of workplace surveillance can be established when one looks at the process of surveillance which at every stage it gives reason why workplace health surveillance has to take place. First, the overall surveillance is perceived to start from the aspect of formulating a statement of the health problem, which will inspire the collection of data (Healey and Lesneski, 2011). After this step has been established and fulfilled, the second step involves identifying the pertinent risk factor, which in most cases constitutes attempts to find the cause of the identified problem. Success at this point will automatically lead to third step, which involve assessing the different available solutions to the identified problems. Here, cost-benefit analysis becomes vital especially with consideration of organizational resources (Healey and Lesneski 2011). The third step will lead to the final step, which involves implementation of system whereby consideration is made whether to pursue active or passive surveillance (Healey and Lesneski, 2011). From the above surveillance process, it can be deduced that workplace health surveillance is carried out majorly to identify the incidence and prevalence of occupational diseases and injuries (Rom 2007). Appropriate and sometime accurate information are required to ensure designing of effective control and prevention measures. Such realization only come possible when efficient health surveillance is carried out that identifies present or possible occupational diseases and injuries. Moreover, as the nature and environment of workplace continue to change, there is need for thorough assessment of nature, magnitude, and distribution of workplace diseases and injuries that in turn can lead to informed decision-making and program implementation. Assessment and acquisition of such information become possible specifically through conducting health surveillance in the workplace (Rom 2007). CCH Australian Limited & OHS industry and legal authorities (2007) observe that the need and frequency of health surveillance should be determined on case-by-case basis taking into consideration health hazards of the particular agent or agents’ ands also the level of exposure. As a result, the purpose of conducting workplace health surveillance is associated with the need to identify the particular increased risks in the workplace environment. The exercise is also carried out to comply with statutory health surveillance requirements, and the need to detect emergence of diseases and injuries in early stage (CCH Australia Limited and OHS industry and legal authorities 2007). Moreover, the purpose of the exercise is premised in the need to carry out comprehensive evaluation of the effectiveness of control measures, carry out thorough investigation of health needs and risks of different categories of employees and lastly, ensure there is a body of epidemiology and disease information that can be critical to decision making process in the organization (CCH Australia Limited and OHS industry and legal authorities, 2007). Types of health surveillance Five major categories of health surveillance have been identified by occupational practitioners. It should be noted that, undertaking surveillance activities is always bestowed in the hands ands experts or qualified practitioner who may carry out survey in one or multiple of the identified health surveillance. The identified five types of health surveillance comprise baseline health surveillance, exit health surveillance, biological monitoring surveillance, biological effect surveillance, and health monitoring survey (CCH Australia Limited and OHS industry and legal authorities 2007). Baseline health surveillance usually involves conducting pre-employment or pre-placement health assessment and in most cases provides information and statistics for future health promotion initiatives. At the same time, this type of surveillance may be carried out to ascertain the level of disability while at the same making assessment of workplace adjustments or accommodations. DeKoning (2006) observes that collection of baseline health data is essential in fulfilling three major needs. The major needs include data collected, which is used to evaluate health risks and behaviors before employees can be allowed in particular workplace environment; to gain understanding of employee deployment activities and the general impact they will be subjected to as a result of exposure to different workplace activities and environment. This is addition to developing and assessing intervention and prevention programs for protection of employee health (DeKoning, 2006). Exit health surveillance normally involves carrying out assessment exercises on employees leaving the company as a result of retirement, retrenchment, or illness. The basis of the assessment normally aims to record specific level of disability, injury or illness the employee may manifest upon leaving the company (Gardiner and Harrington, 2005). Such collected data provide little room to make any prediction about a particular injury or hazards and therefore the essence of information may be largely for information seeking rather than action-oriented. Health surveillance type also includes the biological monitoring surveillance. This health surveillance type involves wide measurement and assessment of risk agents, together with their metabolites in bodily tissues, fluids, secreta, excreta or even a combination of these (Gardiner and Harrington, 2005). Aim of carrying out biological monitoring process, revolves around making evaluation of the exposures and related health risks. Success of biological monitoring depends on availability of adequate and valid method of measurement and availability of means to decide on the extent of exposure and risk to health (Gardiner and Harrington, 2005). The fourth type is the biological effect monitoring which according to Gardiner and Harrington (2005) constitutes early assessment of physiological and biological effects that may lead to emergence of disease or health impairment. The effect in normal circumstances may not be adverse to health but the essence of such assessment usually aims at detecting how well or risky the general working environment with regard to biological aspects. Examples of biological effect monitoring include detection of free erythrocyte protoporphyrin (FEP) in blood, workers exposed to inorganic lead and serum cholinesterase depression in workers exposed to organophosphate pesticides (Gardiner and Harrington, 2005). The last type of surveillance is the health monitoring in which case employees are physically examined using clinical instruments and the major aim is always to detect early health effects. This type of surveillance in most cases may include specific medical examination, which are organic-specific, investigation of audiometry, spirometry, or even electrocardiograph (CCH Australia Limited and OHS industry and legal authorities, 2007). Evidence-based analysis of health surveillance issue: occupational Asthma Workplace conditions have been identified to contribute to occupational asthma, which accordingly is defined as, “a disease of variable airflow limitations and/or airway hyper-responsiveness due to causes and conditions attributable to a particular occupation environment and not stimuli that are being encountered outside the workplace” (Sigsgaard and Heederik 2009, p.71). It is estimated that 15% of adults who have been diagnosed with the disease reside in westernized industrial countries (Szefler and Leung 2001; Douglas 2010). Workers who normally become victims of the disease have manifested reduced quality of life and usually tests confirm the disease is linked to poor work-related environment (Douglas and Elward, 2010). Today the disease remains common in workplaces but at the same time, it remains unrecognized health problem (Douglas, 2010). Given that early recognition of the disease, followed by treatment and subsequent management are critical in improving long-term prognosis, there is need for workplace occupational health officers to carry out frequent assessments that identify the causes of the disease, as well as measures that treatment and management planning can have (Gershwin, Albertson, and Albertson 2011). Assessment of occupational asthma should be evidence-based in nature, whereby health surveillance should be carried out after establishment of healthcare philosophy and health policy in the organization (Zahran, Bailey, and Garbe, 2011). Health surveillance should involve all population considered to be at risk of occupational asthma. The process of surveillance should start with administration of pre-employment screening questionnaires and baseline lung function tests (Sigsgaard and Heederik, 2009). The questionnaires should be able to generate information on numerous aspects that may include people with poorly discriminating factors such ass atopy, family, or individual history of asthma, cigarette smoking, and presence of human leukocyte antigen phenotypes (Sigsgaard and Heederik 2009). Further, employee tests should include skin-prick testing and immunological surveillance, that together with clinical history and lung functions tests should be able identify employees at risk (Sigsgaard and Heederik, 2009). In this entire process of health surveillance, employees need to aware of what is going on, risks of developing the disease and encouraged to report early symptoms. Presence of the disease and related risk factors identified through health surveillance should form basis for decision-making process to take place. Decisions such as; to remove employees at risk from continued exposure to the risks of disease, overall re-assessment and re-design of workforce, initiation of regular environmental measurement, and early prevention of inhaling of allergen, may be adopted (Douglas, 2010). During the entire process of health surveillance, observance of existing legislations and laws should remain the cornerstone of the process. Moreover, communication of the findings and subsequent adoption of critical measures will be important, hence, communication processes and strategies should remain clear, acceptable, influencing and ease for both stakeholders. In summary, it can be stated that, the entire process of health surveillance of occupational asthma should be cooperative and collaborative in nature, observance of laws and respect for employees involved and the findings should promote improvement and change of the workplace environment and structures. Legal requirements for conducting health surveillance It was established earlier that numerous changes are taking place in the workplace that requires interaction and functioning of different social structures of economy, legal, political and health. The legal aspect is the one influencing modern health surveillance activities, as more laws and legislative Acts become part of the overall operating system of health surveillance. Before exploring the issue deeply it should be known that there are some situations that prompts health surveillance under specified regulations. At the same time, there are other circumstances where health surveillance is necessary as general health and safety good practice procedure (Lewis and Thornbory 2010). For instance, the HSE provides clear guidance in form of framework, which individuals and employers can use to assess whether health surveillance is necessary at any given time. According to the outlined health and safety executive (HSE) framework, health surveillance becomes possible under any of the following circumstances: there exist an identifiable disease, risk, or deteriorating health condition, which has to do with the concerned work (Lewis and Thornbory, 2010). Further, health surveillance can become possible when there is presence of valid techniques, which can be used effectively in identifying the disease or conditions present. Moreover, HSE explains that health surveillance may be undertaken when there is likelihood a particular work may results into specific disease or condition hence need to design preventive measures early (Lewis and Thornbory, 2010). Different Acts and laws outlines procedural regulations that employers need to observe in order to prevent or adopt steps that aim at mitigating the occurrence of risks or health hazards. Such steps that are prescribed within the body of law touches on key areas of: assessment, control of employee exposure to harmful workplace environmental conditions, and evaluation and examination of control measures (Lewis and Thornbory 2010). In addition, the laws have expressively outlined the ways and need to provide appropriate information, instruction, and training to employees in order to prepare and equip them with skills of protection in the workplace (Stewart, 2008). Lastly, legislative Acts and laws also contain requirements for employees to develop procedures that are relevant in dealing with accidents, incidents, and emergencies originating from harmful and dangerous substances (Lewis and Thornbory, 2010). Davies (2010) observes that the legal requirement for health surveillance become inevitable specifically with regard to the following aspects. When employers knowingly or unknowingly expose their employees to risky and injurious hazards, when umbrella bodies within health sector express the need for health surveillance to be undertaken and when employees are subjected to night jobs or shifts then health assessment may be required. Legislative Acts have become prominent in demanding and guiding the process of workplace health surveillance. Numerous legislative Acts exist today that tend to guide the larger process of health and surveillance in the workplace. Some of the notable legislative Acts include Health and Safety at Work Act 1974; Ionizing Radiations Regulation Act 1999; Opticians Act 1989, and Sight Testing Regulations Act 989 (Davies 2010). Others include: Health and Safety Regulations 1992; Manual Handling Operations Regulations 1992; Management of Health and Safety at Work Regulations 1999; Control of Substances Hazardous to Health Regulations 2005; and Noise at Work Regulations 2005 (Davies, 2010). The functioning of the Acts can be captured in the following two examples, the Ionizing Radiations Regulation Act of 1999, establishes that all those employees exposed to ionizing radiation should be subjected to regular and periodic surveillance by a qualified medical professional (Lewis and Thornbory, 2010). The surveillance usually in this area starts during pre-employment to access the health issues and the fitness of the employee to adapt. Subsequently, periodic review involves giving questionnaires to employees to complete which may be evaluated by occupational health officer for appropriate decision-making. Another legislative Act is the Control of Noise at Work Regulation 2005 that tends to regulate amount of noise in the environment. What the law prescribes is that employees are supposed to carry out risk assessment of noise in the workplace and effectively put in place a hearing protection program (Lewis and Thornbory 2010). The established program should aim to reduce noise and institute control measures, which may include re-designing work pattern and minimizing access to noisy areas in the workplace. It is further observed that, in circumstances no specific duty on the employer to conduct health surveillance is provided, always reference may be made to Section 2 of the Health and Safety at Work Act 1974, whereby general employer duties are identified as to why health surveillance should be carried out (Davies, 2010). Role of occupational health in responding to surveillance findings Occupation health as a field can be regarded to contribute greatly to the generation and implementation of health surveillance data and findings. Through occupation health knowledge and practice, professionals are trained and equipped with requisite skills and knowledge, which they later utilize in health surveillance activities and subsequent implementation of results. This largely become possible especially if one considers the immense role occupation health present to practitioners. First, occupation health practitioners are impacted with adequate knowledge concerning the need to carry out periodical examinations and medical supervision of employees exposed to special hazards (Kloss, 2010). The findings from the examinations need to be utilized and occupation health practitioners take upon themselves the responsibility of providing advice to the company’s management team on the suitability of the working environment in relation to health, the occurrence and significance of hazards, the health aspects of safety, and more so, the statutory requirements in relation to health. At the same time, it is noted that surveillance results are always accompanied with recommendations that should be adopted and implemented. In order to realize effective implementation, occupation health experts have been critical in ensuring employees are taken through health education that aims at empowering employees to identify and prevent certain specific hazards (Kloss, 2010). Therefore the role of occupation health in responding to surveillance findings is captured in the way the field’s knowledge is utilized in implementing the surveillance results and also how the knowledge of the field is used I generating the information and data of the surveillance. Occupation health professionals have become pivotal elements in conducting health assessment and surveillance and subsequently implementing the results. Communicating surveillance results to employees and managers Parvanta (2011) notes that risk communication that may include public communication need to carefully consider what audiences want from public health information. In this way, the author postulate four questions that occupational health therapist should put in consideration when communicating surveillance results. The questions proposed include: what are the findings which employees and employers need to know, why the identified findings about hazards or injuries took place, what does the results imply, and lastly, what actions are needed as a result of the findings (Parvanta, 2011). As a result, the author identifies the important factors that should be considered when communicating scientific information including surveillance information: content, context, and overload (Parvanta, 2011). Content has to do with the packaging of the information, identifying specifically which information of the findings will be communicated to employees and employers. Context on the other hand has to do with presenting the findings to the target population more effectively while providing and suggesting alternatives that can be used to deal with the identified problem. Lastly, overload has to do with presenting sieved information, which clearly touches the needs of employees and employers. The effort of the communicating source should be to condense the findings into essential information, which can be communicated to employees and employers (Parvanta, 2011). Sadhra and Rampal (1999) observe that the process of risk communication takes into account numerous factors such as general awareness of the hazards in the workplace by employees, the speed with which information can be disseminated, the level of concern the employees possess with regard to adverse effects, and the loss of trust in traditional communication sources. Moreover, suggestion has been made which postulate that the process of risk communication should be premised on the understanding of risk perception among the employees and employers to ensure maximum satisfaction among these groups. Given that communication constitutes exchange of information, Covello (1992) perceives that trust and credibility are paramount for risk communication to succeed (Sadhra and Rampal, 1999). The understanding is that the occupation health officer needs to establish trust and credibility among the various audiences information will be relayed to in order to achieve the objectives of the surveillance exercise (Sines, Appleby and Frost 2005, pp.41-45). More so, trust and credibility to be realized there will be need to consider four aspects of caring, competence, honesty, and dedication (Sadhra and Rampal, 1999). The overall goal here is to establish an environment that is perceived to be empathetic between employees and the occupation health officer, where employees regard the officer to be good listener, interested in their needs and concerned about their welfare (Sadhra and Rampal, 1999). Communicating health surveillance findings can be perceived to be part of risk communication whereby the presence and prevalence of particular risk or hazard has to be known by the affected population (Goldfrank and Flomenbaum 2006, p.1667). As a result, Stellman and International Labour Office (1998) express that the main aim of risk communication should be to identify the controversial characteristics of the risk seen to exist and attempt should further be made to present and explain the risk information to the concerned parties. Further, there should be attempts to influence risk-related behaviors of the individuals, develop information strategies for emergency cases, and put in place a dynamic-cooperative and participative conflict resolution mechanisms concerning the risks and hazards present (Debra et al. 2011). Nevertheless, it should also be remembered that the entire process of risk communication should be premised on the need to use plain and unsophisticated language that employees and employers can understand and trust should be the key to succeed in this process (Lingard and Rowlinson 2005). Quality assurance systems and processes The wider profession of occupation health functions on the need for occupational professionals to participate in processes of providing high quality occupational health services (OHS) in the different organizations and environments (Hasselhorn, Toomingas and Lagerstrom, 1999). The basic understanding here is that, before occupational health activities can take place there is need to have a documented statement of purposes and objectives of OHS. In order to have the statement in place, the first requirement is to carry out a comprehensive assessment of the needs in the organization (Hasselhorn, Toomingas and Lagerstrom 1999). This should be followed by concerted efforts to establish specific and detailed statements with regard to organizational structures, resources, staff competencies, policies, and procedures that are bedrock for quality assurance (Tar-Ching, Gardiner, and Harrington, 2007, p.22). When the above steps have been fulfilled, the next thing to do is to carry out audit with aim to establish quality substance of the above stated aspects and the audit should include the final output of OHS whereby evidence-based criteria should be adopted (Hasselhorn, Toomingas and Lagerstrom, 1999). What should be known here is that quality assurance of health surveillance in the organization originates from tendency to comply with internal and external quality standards and the need to undertake an audit of systematic review of the structure, process, together with outcome and the aim remaining to carry out improvement of quality. Acutt and Hattingh (2003) ascertain that workforce surveillance activities should be established on the need to carry out monitoring of organizational health care needs and the goal need to be the desire to establish degree of success realized and the overall effectiveness and efficiency of the programs. What quality assurance does here is to identify practical changes that can be initiated in the surveillance activities or processes after highlighting and establishing the shortcomings (Oakley 2008). In this purview, it has been suggested that auditing for quality assurance should take place every year and aspects to put into consideration include quality health environment, cost-effectiveness of surveillance activities and processes and legal compliance with regard to surveillance. As a result, in undertaking quality assurance of health surveillance, Acutt and Hattingh (2003) note that the aim is always to institute a systematic evaluation of workplace health needs that should results in changes such as adoption and adaptation of technology, treatment, knowledge, legislation, and overall organization’s health needs. Therefore, in conclusion it can be stated that, quality assurance programme in an organization should start from outline of planning process of the occupational health services, and subsequently followed by creating a healthcare philosophy and health policy. In the entire process of quality assurance, the program should be premised on client-based needs and satisfaction (Oakley, 2008). These aspects will enable the process of addressing workplace health needs to be realized effectively. Conclusion Today, it can be stated that numerous laws have been formulated that guide observance of safe workplace environment where at the same time, health surveillance has been adopted as common practice in many workplaces (Chambers, 2001). Evidence show that, in modern day organizations, is almost becoming mandate for employers to carry out health surveillance of their employees and general working environment in which case the goals are to identify the specific hazards employees may be exposed to. Numerous workplace hazards have been identified in the workplace and they may include lead, ionizing radiations, hazardous chemical or biological agents, and asbestos (Chambers, 2001). In the midst of all these hazards, it has been recommended that health surveillance should be carried out on the general environment in which employees operate especially with regard to residual risks. At the same time, health surveillance has been recommended especially when the aim is to detect the work-related conditions and how well the employees can be protected from the harm. On overall, the research paper has established that workplace health surveillance become functional when aspects of: proper communication, appropriate evaluation and auditing, participation and collaboration of key stakeholders and observance of legislations and laws are realized. References Acutt, J & Hattingh, S 2003, Occupational health: management and practice for health practitioners, Juta and Company Johannesburg, viewed 21 September 2011, http://books.google.com/books?id=uptThLmdhxYC&pg=PA238&dq=Quality+assurance+of+workplace+health+surveillance+activities&hl=en&ei=-VB7Tt-OAYSe-wbN1oVJ&sa=X&oi=book_result&ct=result&resnum=9&ved=0CGAQ6AEwCA#v=onepage&q&f=false. Chambers, R 2001, Occupational health matters in general practice, Radcliffe Publishing, London, Viewed 21 September 2011, http://books.google.com/books?id=exSQjxXgr3YC&pg=PA11&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=3o95Ts-ML4nBswbgpIjZDw&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDQQ6AEwAQ#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. CCH Australia Limited & OHS industry and legal authorities 2007, Australian master OHS and environment guide, CCH Australia Limited, Sydney, viewed 21 September 2011, http://books.google.com/books?id=TtIBIuVhXoYC&pg=PA187&dq=TYPES+OF+WORKPLACE+HEALTH+SURVEILLANCE&hl=en&ei=3hB6TrNKyYD7Bti4uCU&sa=X&oi=book_result&ct=result&resnum=6&ved=0CEoQ6AEwBQ#v=onepage&q=TYPES%20OF%20WORKPLACE%20HEALTH%20SURVEILLANCE&f=false. Debra, R, Kailey, N, Hanne, T, Jeffrey, D & Baseman, J 2011, Public health emergency preparedness and response communications with health care providers: A literature review, BMC Public Health, vol. 11, no. 4, pp. 337-344, Viewed 21 September 2011, http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=13&hid=15&sid=cc921a83-2410-4930-89bd-b45d27e7961f%40sessionmgr14. DeKoning, BL 2006, Recruit medicine, Government Printing Office WA, viewed 21 September 2011, http://books.google.com/books?id=bqX4inSQ0jUC&pg=PA82&dq=baseline+health+surveillance&hl=en&ei=A2F6TrfgNo7s-gb6t7xJ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDQQ6AEwATgK#v=onepage&q=baseline%20health%20surveillance&f=false. Davies, A 2010, Workplace law handbook 2011 - Health and safety, premises and environment handbook, Workplace Law Group, London, Viewed 21 September 2011, http://books.google.com/books?id=2wWHm_EjwMQC&pg=PA356&dq=control+of+vibration+at+work+regulation+Act+2005&hl=en&ei=EXt6TseTIsye-wantO1c&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDoQ6AEwAg#v=onepage&q=control%20of%20vibration%20at%20work%20regulation%20Act%202005&f=false. Douglas, JG & Elward, KS 2010, Asthma: Clinician's desk reference, Manson Publishing, London, Viewed 21 September 2011, http://books.google.com/books?id=gS4BsugTBvoC&pg=PA91&dq=occupational+Asthma&hl=en&ei=o1t7TsHLH8nt-gaH84Ux&sa=X&oi=book_result&ct=result&resnum=4&ved=0CEIQ6AEwAw#v=onepage&q=occupational%20Asthma&f=false. Douglas, JD 2011, Occupational asthma, Practice Nurse Journal, vol. 40, no. 4, pp. 19-24. Viewed 21 September 2011, http://web.ebscohost.com/ehost/detail?vid=13&hid=15&sid=cc921a83-2410-4930-89bd-b45d27e7961f%40sessionmgr14&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&AN=53907949. Gardiner, K & Harrington, JM 2005, Occupational hygiene, Wiley-Blackwell, West Sussex, Viewed 21 September 2011, http://books.google.com/books?id=6esjsW_6CskC&pg=PA160&dq=biological+monitoring+surveillance&hl=en&ei=PGl6TsKsCI3s-gbAgtRJ&sa=X&oi=book_result&ct=result&resnum=6&ved=0CFAQ6AEwBQ#v=onepage&q=biological%20monitoring%20surveillance&f=false. Gershwin, ME, Albertson, TE & Albertson, TE 2011, Bronchial asthma: A guide for practical understanding and treatment, Springer, London, viewed 21 September 2011, http://books.google.com/books?id=si5pQj8SaBwC&pg=PA16&dq=occupational+Asthma&hl=en&ei=o1t7TsHLH8nt-gaH84Ux&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEgQ6AEwBA#v=onepage&q=occupational%20Asthma&f=false. Goldfrank, LR & Flomenbaum, N 2006, Goldfrank's toxicologic emergencies, McGraw-Hill Professional, London, viewed 21 September 2011, http://books.google.com/books?id=cvJuLqBxGUcC&pg=PA1667&dq=effective+way+of+communicating+occupational+health+surveillance+results&hl=en&ei=JnJ7TsaTLoKx8QP9zMCyBg&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEcQ6AEwBDgK#v=onepage&q&f=false. Hasselhorn, HM, Toomingas, A & Lagerstrom, M 1999, Occupational health for health care workers: a practical guide, Elsevier Health Sciences, London, viewed 21 September 2011, http://books.google.com/books?id=Sm9kylFTZ5YC&pg=PA16&dq=Quality+assurance+systems+and+processes+in+health+surveillance&hl=en&ei=x0h7TsDqJcv_-gaxytxC&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEoQ6AEwBA#v=onepage&q&f=false. Healey, BJ & Walker, KT 2009, Introduction to occupational health in public health practice, John Wiley and Sons, West Sussex, Viewed 21 September 2011, http://books.google.com/books?id=qpG6EuGEKO4C&pg=PA31&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=3o95Ts-ML4nBswbgpIjZDw&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDkQ6AEwAg#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. Healey, BJ & Lesneski, CD 2011, Transforming public health practice: Leadership and management essentials. John Wiley and Sons, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=z_O-BS8b4ucC&pg=PT95&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=Rgl6TpCVJc2e-waX1IVY&sa=X&oi=book_result&ct=result&resnum=9&ved=0CFsQ6AEwCDgK#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. Kloss, D 2010, Occupational health law, John Wiley and Sons, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=syOlqB4Wjc4C&pg=PA34&dq=occupation+health+practice+and+health+surveillance+findings&hl=en&ei=EYd6Tv61E8-fOqG_lLMC&sa=X&oi=book_result&ct=result&resnum=4&ved=0CEUQ6AEwAw#v=onepage&q&f=false. Lewis, J & Thornbory, G 2010, Employment law and occupational health: A practical handbook, John Wiley and Sons, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=JQlsX4Nvx8AC&pg=PA74&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=3o95Ts-ML4nBswbgpIjZDw&sa=X&oi=book_result&ct=result&resnum=4&ved=0CD8Q6AEwAw#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. Lilley, R & Feyer, AM 2010, Surveillance of working conditions and the work environment: development of a national hazard surveillance tool in New Zealand, International Journal of Public Health, Vol. 55, pp. 49-57, Viewed 21 September 2011, http://proquest.umi.com/pqdweb?index=2&did=1963690991&SrchMode=1&sid=2&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1316598398&clientId=29440. Lingard, H & Rowlinson, SM 2005, Occupational health and safety in construction project management, Taylor & Francis, London, viewed 21 September 2011, http://books.google.com/books?id=Pu8Abt1vsPQC&pg=PA225&dq=occupation+health+risk+communication+process&hl=en&ei=GeB6Tp_nK4248gOKu-wt&sa=X&oi=book_result&ct=result&resnum=3&ved=0CEIQ6AEwAg#v=onepage&q&f=false. Oakley, K 2008, Occupational health nursing, John Wiley and Sons, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=lbZrqMpPEAQC&pg=PA80&dq=quality+auditing+of+occupational+health+surveillance&hl=en&ei=MnR7Tou_JIqw8gO0-9EU&sa=X&oi=book_result&ct=result&resnum=2&ved=0CEMQ6AEwAQ#v=onepage&q=quality%20auditing%20of%20occupational%20health%20surveillance&f=false. Parvanta, CF 2011, Essentials of public health communication, Jones & Bartlett Publishers, Norfolk, viewed 21 September 2011, http://books.google.com/books?id=FPrIgJslUeQC&pg=PA62&dq=communicating+health+surveillance+findings&hl=en&ei=8496TvLPMIadOvqbmMEC&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDMQ6AEwAA#v=onepage&q=communicating%20health%20surveillance%20findings&f=false. Rom, WN 2007, Environmental and occupational medicine, Lippincott Williams & Wilkins, London, viewed 21 September 2011, http://books.google.com/books?id=H4Sv9XY296oC&pg=PA10&dq=workplace+health+surveillance&hl=en&ei=p7p5Tu-sN8Hs-gbf2Nwf&sa=X&oi=book_result&ct=result&resnum=10&ved=0CGIQ6AEwCQ#v=onepage&q=workplace%20health%20surveillance&f=false. Rubertone, MV & Brundage, JF 2002, The defense medical surveillance system and the department of defense serum repository: Glimpses of the future of public health surveillance, American Journal of Public Health, vol. 92, no. 12, pp. 1900-1904, viewed 21 September 2011, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447349/. Sadhra, SS & Rampal, KG 1999, Occupational health: risk assessment and management, Wiley-Blackwell, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=efTql13rubUC&pg=PA300&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=Rgl6TpCVJc2e-waX1IVY&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC4Q6AEwADgK#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. Sigsgaard, T & Heederik, D 2009, Occupational asthma, Springer, London, viewed 21 September 2011, http://books.google.com/books?id=Og5mLX5709oC&printsec=frontcover&dq=occupational+Asthma&hl=en&ei=o1t7TsHLH8nt-gaH84Ux&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC8Q6AEwAA#v=onepage&q&f=false. Sines, D., Appleby, FM., & Frost, M 2005, Community health care nursing. Wiley-Blackwell, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=fHMWbpG-YZsC&pg=PA200&dq=effective+way+of+communicating+occupational+health+surveillance+results&hl=en&ei=2G57TviAM4Oi8QP_sMhA&sa=X&oi=book_result&ct=result&resnum=8&ved=0CFYQ6AEwBw#v=onepage&q&f=false. Stellman, JM & International Labour Office 1998, Encyclopedia of occupational health and safety, International Labor Organization, Geneva:. Viewed 21 September 2011, http://books.google.com/books?id=vW6rXFvm4sQC&pg=PT451&dq=Practice+of+Health+Surveillance+in+the+Workplace&hl=en&ei=3o95Ts-ML4nBswbgpIjZDw&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEUQ6AEwBA#v=onepage&q=Practice%20of%20Health%20Surveillance%20in%20the%20Workplace&f=false. Stewart, A 2008, Stewart's guide to employment law, Federation Press, viewed 21 September 2011, http://books.google.com/books?id=maniSB_tIYcC&pg=PA261&dq=occupational+health+law&hl=en&ei=V4N6TsTDOsGaOsvOoL8C&sa=X&oi=book_result&ct=result&resnum=8&ved=0CF8Q6AEwBw#v=onepage&q=occupational%20health%20law&f=false. Szefler, SJ & Leung, DY 2001, Severe asthma: pathogenesis and clinical management. CRC Press. Viewed 21 September 2011, http://books.google.com/books?id=vPFRUS0xBYwC&pg=PA381&dq=occupational+Asthma&hl=en&ei=o1t7TsHLH8nt-gaH84Ux&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDwQ6AEwAg#v=onepage&q=occupational%20Asthma&f=false. Tar-Ching, A., Gardiner, K., & Harrington, JM 2007, Pocket consultant: Occupational health, John Wiley and Sons, West Sussex, viewed 21 September 2011, http://books.google.com/books?id=xU2wzZHJ4XAC&pg=PA22&dq=quality+auditing+of+occupational+health+surveillance&hl=en&ei=MnR7Tou_JIqw8gO0-9EU&sa=X&oi=book_result&ct=result&resnum=9&ved=0CGsQ6AEwCA#v=onepage&q&f=false. Zahran, HS., Bailey, C., & Garbe, P 2011, Vital signs: Asthma prevalence, disease characteristics and self-management education-United States, 2001-2009, Morbidity & Mortality Weekly Report, vol. 60, no. 17, pp. 547-552, viewed 21 September 2011, http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=12&hid=15&sid=cc921a83-2410-4930-89bd-b45d27e7961f%40sessionmgr14. Read More