Buijs P, Dijk F van. Essential interventions on Workers’ Health by Primary Health Care.
A scoping review of the literature: a technical report. March 2014. TNO Work, Health and Care, The Netherlands. Report R10755. Copyright TNO. Open Access.
Conclusions (shortened, see also the Recommendations)
1. A variety of primary health care activities for workers’ health are reported from different regions of the world, demonstrating that essential interventions are applied in a wide diversity of countries and situations. Structured large-scale programs involving primary and community health care in new activities on workers’ health started recently in a few countries. This is demonstrating the pioneering status of these programs. Many small-scale activities can be noted in a wide variety of countries.
2. Based on the literature search we conclude that essential interventions on workers’ health on the level of primary, secondary and tertiary prevention as proposed for primary health care are supported to a greater or lesser extent by evidence from the scientific and gray literature.
- Primary prevention activities – including workplace visits – can be part of PHC interventions. Serious limitations in PHC interventions can be found in more complex activities where experts are needed such as for most risk assessments and advises regarding more complicated improvements of working conditions. Education and training in prevention and health promotion can be executed by primary health care professionals.
- Primary health care may perform periodic general health examinations to detect work-related health problems and occupational diseases. Screening tests as part of a workers’ health surveillance program such as for pesticide poisoning or exposure, can be performed under the condition of guidance by experts. Tools and education are available for primary health care to detect occupational diseases in daily practice.
- Tertiary prevention activities may include first aid services and emergency treatment by primary health care and consultations of working patients regarding health and work ability. In several countries the attitude and communication skills of GPs (general practitioners, family physicians) regarding work have to improve. New tools can lead to more GP knowledge on the risks for long-term sickness absence and to better advices toward patients with a chronic disease. Employment advisors and GPs with extra training in occupational medicine obtained good results.
3. The integration of a number of activities on workers’ health in primary or community health care has many advantages and should be promoted, but also that primary health care can only work structurally when supported by an infrastructure involving experts of various disciplines in occupational health and safety.
4. The level of evidence about the feasibility of programs aimed to encourage and support primary health care interventions for workers’ health is high as can be shown by a number of impressive programs from Thailand, China, UK, Indonesia and other countries. Large-scale primary health care interventions have to be supported by a programmatic approach including investments in infrastructure – among others organizing expert support -, tool development and education and training of primary health care personnel.
5. The level of evidence regarding the effectiveness of the interventions is not high. There is an urgent need for scientific sound but practical implementation and evaluation studies. Such studies need to be planned from the very beginning of projects and programs.