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ABSTRACT: The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; addressing mental health; collaborating on employer benefits design; developing programs for global health, travel medicine, and remote/extreme environments; overseeing on- and near-site clinics; incorporating digital technology, artificial intelligence, and telehealth in health programs; supporting critical incident preparedness and business continuity planning; addressing workplace hazards; and overseeing periodic executive health examinations.
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Diretores Médicos , Humanos , Pandemias/prevenção & controle , Inteligência Artificial , Local de Trabalho , ComércioRESUMO
OBJECTIVE: To determine whether temperature screening is useful in detecting and reducing workplace transmission of SARS-CoV-2. METHODS: A survey was conducted to determine whether temperature screening successfully identified workers with coronavirus disease 2019 (COVID-19) among a convenience sample of medical directors of multinational corporations in a wide range of industries. RESULTS: More than 15 million screenings were performed by 14 companies. Fewer than 700 episodes of fever were identified. Of these, only about 53 cases of COVID-19 were detected. By contrast about 2000 workers with diagnosed COVID-19 were in the workplace and not detected by screening. CONCLUSIONS: One case of COVID-19 was identified by screening for approximately every 40 cases that were missed. Worksite temperature screening was ineffective for detecting workers with COVID-19 and is not recommended.
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COVID-19 , Local de Trabalho , Humanos , Programas de Rastreamento , SARS-CoV-2 , TemperaturaRESUMO
: The role of the corporate medical director (CMD) has evolved over the last 300 years since Ramazzini first identified diseases of Italian workers in the early 1700s. Since then, there has been a gradual blurring of the boundaries between private and workplace health concerns. Today's CMD must have intimate knowledge of their corporation's industry and the businesses that they support, particularly the occupational and environmental programs that comply with all local, state, and/or national standards and regulations. Leading companies not only measure compliance with such standards but also may hold programs to their own internal corporate global standards even if these go beyond local government requirements. This document will explore in greater depth the strength and importance that the CMD brings to the business operations to support a healthy, engaged, and high performing workforce. Part 1 describes the role and value of the CMD, while Part 2 provides collective wisdom for the new CMD from current and past highly experienced CMDs.
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Saúde Ocupacional , Diretores Médicos , Papel Profissional , Política de Saúde , Humanos , Liderança , Saúde Mental , Estados UnidosRESUMO
OBJECTIVE: To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage. METHODS: We searched PubMed from 2011 to 2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace. RESULTS: A total of 1419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and investigation. CONCLUSIONS: Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight.
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Cobertura do Seguro , Seguro Saúde , Obesidade/terapia , Exposição Ocupacional/efeitos adversos , Saúde Ocupacional/normas , Segurança , Cirurgia Bariátrica/economia , Custos de Cuidados de Saúde , Humanos , Estilo de Vida , Obesidade/economia , Obesidade/etiologia , Local de TrabalhoRESUMO
OBJECTIVE: To better understand how integrating health and safety strategies in the workplace has evolved and establish a replicable, scalable framework for advancing the concept with a system of health and safety metrics, modeled after the Dow Jones Sustainability Index. METHODS: Seven leading national and international programs aimed at creating a culture of health and safety in the workplace were compared and contrasted. RESULTS: A list of forty variables was selected, making it clear there is a wide variety of approaches to integration of health and safety in the workplace. CONCLUSION: Depending on how well developed the culture of health and safety is within a company, there are unique routes to operationalize and institutionalize the integration of health and safety strategies to achieve measurable benefits to enhance the overall health and well-being of workers, their families, and the community.
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Promoção da Saúde/organização & administração , Saúde Ocupacional/normas , Cultura Organizacional , Indicadores Básicos de Saúde , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Garantia da Qualidade dos Cuidados de Saúde , Estados Unidos , Local de Trabalho/organização & administraçãoRESUMO
OBJECTIVE: To identify reasons for air medical evacuations from oil rigs/platforms. METHODS: Retrospective review of data of medical calls from 102 rigs/platforms in the US Gulf Coast from 2008 through 2012 with specific analysis of medevacs. RESULTS: On average, 1609 total calls per year relating to illness or injury on the 102 oil rigs/platforms with 4% to 7% requiring medical air evacuation. On average, 77% of medevacs were for nonoccupational medical injury or illness. CONCLUSIONS: Illness, not occupational injuries, is identified as the major reason for medical evacuations from oil rigs. Heart disease is the leading cause of chronic health conditions resulting in a medevac.
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Acidentes de Trabalho/economia , Resgate Aéreo/economia , Traumatismos Ocupacionais/economia , Campos de Petróleo e Gás , Local de Trabalho/economia , Acidentes de Trabalho/estatística & dados numéricos , Resgate Aéreo/estatística & dados numéricos , Golfo do México , Humanos , Traumatismos Ocupacionais/epidemiologia , Estudos Retrospectivos , Estados Unidos , Local de Trabalho/estatística & dados numéricosRESUMO
OBJECTIVE: To explore issues related to the aging workforce, including barriers to integrating health protection and promotion programs, and provide recommendations for best practices to maximize contributions by aging workers. METHODS: Workgroups reviewed literature and case studies to develop consensus statements and recommendations for a national approach to issues related to older workers. RESULTS: Consensus statements and actions steps were identified for each of the Summit goals and call-to-action statements were developed. CONCLUSIONS: A national dialogue to build awareness of integrated health protection and promotion for the aging workforce is needed. Workers will benefit from improved health and performance; employers will realize a more engaged and productive workforce; and the nation will gain a vital, competitive workforce.
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Promoção da Saúde , Saúde Ocupacional , Fatores Etários , Pesquisa Biomédica , Coleta de Dados , Humanos , Motivação , Cultura Organizacional , Guias de Prática Clínica como Assunto , Local de Trabalho/organização & administraçãoRESUMO
OBJECTIVE: To understand impacts of medication adherence, comorbidities, and health risks on workforce absence and job performance. METHODS: Retrospective observational study using employees' medical/pharmacy claims and self-reported health risk appraisals. RESULTS: Statin medication adherence in individuals with Coronary Artery Disease was significant predictor (P < 0.05) of decreasing absenteeism. Insulin, oral hypoglycemic, or metformin medication adherence in type 2 diabetics was significant (P < 0.05) predictor of decreasing job performance. Number of comorbidities was found as significant (P < 0.5) predictor of absenteeism in five of nine subsamples. Significant links (P < 0.05) between high health risks and lower job performance were found across all nine subsamples. CONCLUSIONS: Results suggest integrated health and productivity management strategies should include an emphasis on primary and secondary prevention to reduce health risks in addition to tertiary prevention efforts of disease management and medication management.
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Absenteísmo , Avaliação de Desempenho Profissional , Nível de Saúde , Adesão à Medicação/estatística & dados numéricos , Adulto , Doença Crônica/tratamento farmacológico , Comorbidade , Depressão/complicações , Indicadores Básicos de Saúde , Humanos , Formulário de Reclamação de Seguro , Pessoa de Meia-Idade , Análise de Regressão , Estudos RetrospectivosAssuntos
Promoção da Saúde/métodos , Serviços de Saúde do Trabalhador/métodos , Local de Trabalho , Política de Saúde , Promoção da Saúde/organização & administração , Nível de Saúde , Humanos , Cultura Organizacional , Gestão da Segurança/métodos , Estados Unidos , Local de Trabalho/estatística & dados numéricosRESUMO
Malaria continues to be a significant, life-threatening illness in many parts of the world. For corporate travelers from countries with low endemicity, the risk of infection is considerable. Many corporate travelers are unaware of their risk, unsure of the correct preventative measures, and receive incorrect advice regarding prevention or do not comply with advice they have received. This review addresses the risk of malaria to the nonimmune corporate traveler, disease transmission, and recommended means of prevention, including prevention of mosquito bites and antimalaria chemoprophylaxis.
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Antimaníacos/uso terapêutico , Malária/prevenção & controle , Viagem , Algoritmos , Quimioprevenção , Comércio , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Repelentes de Insetos/uso terapêutico , Malária/transmissão , RiscoRESUMO
Cervical cancer, caused by oncogenic types of human papillomavirus (HPV), remains a major health problem worldwide. The recent introduction of a quadrivalent vaccine (Gardasil), which targets HPV strains responsible for approximately 70% of cervical cancer cases and 90% of genital warts, has ushered in new hope of substantially reducing global prevalence of HPV disease. A further bivalent HPV vaccine (Cervarix) is in the offing. However, many issues still need to be addressed, including actual vaccine efficacy in preventing cervical cancer, public acceptance, use of the vaccine in men, vaccine access, costs, and impact of the vaccine on cervical cancer screening programs. This review analyzes some of these issues, and emphasizes the need for a coordinated effort of patients, parents, health professionals, hospitals, and policymakers to ensure successful implementation of vaccination programs in the United States.
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Papillomaviridae/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Comportamento de Redução do Risco , Neoplasias do Colo do Útero/prevenção & controle , Feminino , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18 , Humanos , Masculino , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/virologia , Estados UnidosRESUMO
OBJECTIVE: To review ways in which pharmacists can help health plans shift their focus from cost to value. SUMMARY: Health care delivery is a continuum. Employers have moved along the continuum looking for value; they are now looking for integrated strategies to decrease cost and improve productivity within the workforce. The key to any integrated strategy is innovative service delivery and ground-breaking partnerships with vendors. Key areas that need to be addressed are medical care, pharmacy, behavioral health, disability, prevention, and presenteeism. Additionally, measuring program effectiveness is becoming more important, especially in terms of continuous improvement. CONCLUSION: Updating data, fine-tuning plan design to improve effectiveness, and abandoning ineffective efforts is critical. The ultimate goal is to modify the target population.s risk.
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Prestação Integrada de Cuidados de Saúde/economia , Planos de Assistência de Saúde para Empregados/economia , Promoção da Saúde/economia , Farmacêuticos , Garantia da Qualidade dos Cuidados de Saúde/economia , Benchmarking , Controle de Custos , Prestação Integrada de Cuidados de Saúde/normas , Planos de Assistência de Saúde para Empregados/normas , Custos de Cuidados de Saúde , Promoção da Saúde/métodos , Humanos , Programas de Assistência Gerenciada/economia , Programas de Assistência Gerenciada/normas , Papel Profissional , Garantia da Qualidade dos Cuidados de Saúde/métodos , Estados UnidosRESUMO
OBJECTIVE: We sought to gather employer perspectives about value-focused activities (VFAs), intentions to make decisions based on value, and other factors affecting decisions. METHODS: Health decision-makers (n = 174), both American College of Occupational and Environmental Medicine members and corporate HR/benefits directors, responded to an Internet-based questionnaire. RESULTS: Of a total of 32 listed VFAs, companies reported, on average, performing 5.2 activities currently and considering 2.6. Twenty-five percent of companies reported doing eight or more. The most common VFAs were providing access to flu shots, centers of excellence, and wellness programs. Greater access to detailed outcome data was associated with doing more VFAs, as was greater accountability for absence, disability, and productivity outcomes. CONCLUSIONS: Employers vary widely in the number of VFAs in which they participate. Decision-makers with more information about, and accountability for, value outcomes reported doing more VFAs.
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Tomada de Decisões Gerenciais , Promoção da Saúde/organização & administração , Saúde Ocupacional , Política Organizacional , Distribuição de Qui-Quadrado , Eficiência Organizacional , Humanos , Inquéritos e Questionários , Estados UnidosRESUMO
This report presents an overview of methodological issues in estimating the indirect workplace costs of illness from data obtained in employee surveys using the World Health Organization Health and Work Performance Questionnaire (HPQ). The HPQ is a brief self-report questionnaire that obtains three types of information: screening information about the prevalence and treatment of commonly occurring health problems; information about three types of workplace consequences (sickness absence, presenteeism, and critical incidents); and basic demographic information. The report considers two sets of methodological issues. The first set deals with measurement. The rationale for the HPQ approach to measurement is described in this section. In addition, data are presented regarding the accuracy of HPQ measures, documenting that the HPQ has excellent reliability, validity, and sensitivity to change. The second set of methodological issues deals with data analysis. A number of analysis problems are reviewed that arise in using self-report nonexperimental survey data to estimate the workplace costs of illness and the cost-effectiveness of treatment. Innovative data analysis strategies are described to address these problems.
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Efeitos Psicossociais da Doença , Eficiência , Indústrias/economia , Inquéritos e Questionários , Organização Mundial da Saúde , AbsenteísmoRESUMO
An establishment of health-related productivity measurements and critical evaluation of health-related productivity tools is needed. An expert panel was created. A literature search was conducted to identify health-related productivity measurement tools. Each instrument was reviewed for: 1) supporting scientific evidence (e.g., reliability and validity); 2) applicability to various types of occupations, diseases, and level of severity of disease; 3) ability to translate data into a monetary unit; and 4) practicality. A modified Delphi technique was used to build consensus. The expert panel recommended absenteeism, presenteeism, and employee turnover/replacement costs as key elements of workplace health-related productivity measurement. The panel also recommended that productivity instruments should: 1) have supporting scientific evidence, 2) be applicable to the particular work setting, 3) be supportive of effective business decision-making, and 4) be practical. Six productivity measurement tools were reviewed. The panel recommended necessary elements of workplace health-related productivity measurement, key characteristics for evaluating instruments, and tools for measuring work loss. Continued research, validation, and on-going evaluation of health-related productivity instruments are needed.