Regulatory and Ethical Considerations on Artificial Intelligence for Occupational Medicine.

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.

Assessing the profile and utility of diplomates in occupational medicine.

BACKGROUND: The utility of the occupational medicine diploma in the UK is yet to be explored. The NHS 'Growing Occupational Health (OH) and Wellbeing' programme provides opportunities for diplomates to increase their OH work. AIMS: To assess what proportion of diplomates carry out OH work, the type of work being undertaken, to identify obstacles impeding OH work, to capture their interest in future work opportunities and what additional support they require. METHODS: A link to an online questionnaire was sent to diplomates via several professional bodies; we estimate that 2428 diplomates received this. The survey was open from 24 March to 31 May 2022. RESULTS: Replies were received from 310/2428 (13%) diplomates. Fifty-two per cent of respondents were males and 35% were female. Respondents were diverse in terms of age and geographical region. Main employment settings: 13% primary care, 43% secondary care, 31% private sector, 24% public sector and 20% self-employed. Seventy-two per cent of diplomates had undertaken OH clinical work since completion of their diploma, and 90% of those were undertaking OH clinical work at the time of the survey. Specific obstacles to accessing OH work highlighted included existing workload constraints, lack of employment opportunities with OH providers and lack of time. CONCLUSIONS: Many (126/310; 41%) respondents had considered increasing their OH work in the previous 12 months. Increasing mentorship from senior OH clinicians to diplomates was suggested by 4% of respondents to enhance the utility of diplomates.

Preparation and Challenges in Developing a Big Data Analysis Framework in Occupational Medicine in Indonesia.

This mini review explores the transformative potential of big data analysis and artificial intelligence (AI) in reforming occupational medicine in Indonesia. Emphasizing the preconditions, case studies, and benefits, it underscores the role of big data in enhancing worker well-being. The review highlights the importance of informative health big data, especially in high-risk industries, with examples of case studies of AI implementation in occupational medicine during the COVID-19 pandemic and other relevant scenarios. While acknowledging the challenges of AI implementation, the essay identifies the role of academic and professional organizations as pioneers in big data utilization. Six potential benefits that are identified, including improved patient care and efficient resource allocation, demonstrate the transformative impact of big data analysis. The proposed pathway of preparation underscores the need for awareness, skill enhancement, and collaboration, addressing challenges in data management and stakeholder engagement. The conclusion emphasizes continuous assessment, feasibility studies, and commitment as essential steps in advancing occupational medicine through big data analysis.

Occupational Medicine, Go Above and Beyond.

The population of people in Japan over 65 years old is expected to exceed 30% by 2025. As the society ages, there are not only healthy workers and employers, but also an increasing number of diseased or injured workers. Falls, the most common occupational hazard, increase in incidence with age. The management of osteoporosis and prevention of bone fractures from falls are emerging in elderly female workers, to reduce the loss of work productivity. Rheumatoid arthritis is a representative musculoskeletal disease that causes functional decline because of joint damage mainly in working women, but appropriate treatment improves disease activity and work productivity in workers with rheumatoid arthritis. It is also important not only to digitize subjective information by converting it into digital form (digitization), but also to digitalize the physiological information related to health, labor and disease (digitalization). In the future, artificial intelligence (AI) will be able to analyze vast amounts of physiological information (big data) obtained from workers and patients via the Internet of things (IoT), which will improve the information value linked to health promotion and optimal treatment practices, and contribute to the Digital transformation (DX).

Predictors of the return to work for pregnant employees on preventive leave: Patients from an occupational medicine consultation in Switzerland.

According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company's knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.

Improving undergraduate education of occupational health and occupational medicine appling massive open online courses & problem-based learning.

BACKGROUND: The learning of Occupational Health and Occupational Medicine in undergraduate college students in China has been hindered by various factors. This study aimed to explore the effects of the application of Massive Open Online Courses (MOOC) & Problem-based learning (PBL) in the learning of Occupational Health and Occupational Medicine in undergraduate college students in China. METHODS: Students enrolled in 2017 and 2018 were categorized in the control group and study group, and received PBL learning and MOOC + PBL learning, respectively. The effects of learning were assessed by scores of final exam, satisfaction degree of students, and feedbacks. RESULTS: The mean score of the final exam was not significantly different between the two groups. However, the further comparison by levels of scores showed that the percentages of good and excellent were both significantly higher in the study group than control group. The overall satisfaction degree was significantly higher in the study group than control group. In addition, the scores of the 3 dimensions of satisfaction degree, i.e. learning preparation, learning process, and learning effect, were all significantly higher in the study group than control group. The feedbacks of the students showed that they thought MOOC + PBL learning could better improve the learning efficacy, despite a substantial proportion of students reported that MOOC + PBL learning more time-consuming. CONCLUSIONS: The findings showed that the combination of MOOC and PBL in the learning of Occupational Health and Occupational Medicine is an effective method capable of improving the learning efficacy in college students of Prophylactic Medicine. Further efforts are needed to optimize the MOOC platform to provide a friendlier interface.

Occupational Medicine Physicians Transition to Retirement: An International Survey of Plans, Preparation, and Interests.

OBJECTIVE: The aim of the study is to understand the needs and interests of occupational medicine physicians (OMPs) as they transition to retirement. METHODS: An electronic survey was distributed through member organizations in the United States (ACOEM), United Kingdom (SOM/FOM), India (IAOH), South Africa (SASOM), and Medichem. RESULTS: Four hundred ninety-seven OMPs at various career stages responded, including 282 from the United States, 97 from the United Kingdom, 36 from India, 30 from South Africa, and 52 from other countries. Two hundred seventy-eight work full-time, 160 part-time, and 58 are not doing paid work. Approximately 60% serve as volunteers. Sixty percent have a written financial plan. Thirty-five percent are very comfortable with their retirement plans. After leaving full-time work, 85% plan to work part-time. There is a high level of interest in learning about opportunities for part-time work and volunteering. CONCLUSIONS: Occupational medicine physicians are very interested in learning more about compensated and uncompensated work in retirement.

Noise-induced hearing loss in the pre-industrial era: early contributions in De Morbis Artificum by Bernardino Ramazzini (1633-1714).

OBJECTIVE: Noise-induced hearing loss is the most prevalent occupational disease worldwide and is historically associated with the Industrial Revolution. This study analyses early descriptions of this disorder during the pre-industrial period in the work of the Italian physician Bernardino Ramazzini (1633-1714). METHOD: Primary and secondary historical literature were reviewed. RESULTS: Ramazzini described hearing loss in corn millers and in coppersmiths and recognised that this disorder is irreversible and progressive when exposure to noise continues. He also seemed to describe tinnitus. He further suggested the use of earplugs as a preventive measure for these classes of workers. Ramazzini's anatomical and pathological knowledge appears to be based on ancient authors; he did not discuss contemporaneous medical authors' work on hearing function. CONCLUSION: Despite some limitations, Ramazzini's work appears pioneering for his time and represents an important milestone in the history of otolaryngology.

COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK.

This paper addresses lessons learned from the COVID-19 pandemic from a UK Occupational Medicine perspective to permit comparison with other national accounts. In spite of good prior research and statute, the necessary resources to protect workers' health were seriously lacking when the pandemic struck. Weak public health guidance, which did not recognise dominant airborne transmission, was applied to workplaces, leaving workers and others unprotected, especially in respect to Respiratory Protective Equipment (RPE). The Health and Safety Executive (HSE) as regulator was lacking, for example, in not producing guidance to protect HealthCare Workers (HCW) who were amongst the most at risk. The UK COVID-19 Public Inquiry should address shortcomings such as these, but recommendations must be accompanied by robust means to ensure appropriate implementation. These should range from substantial measures to improve indoor air quality, to a permanent pandemic management organization with adequate resources. The enforcing authority has to be obliged to publish more specific workplace guidance than the public health authorities. Occupational medicine as a discipline needs to be better prepared, and hence to assert its responsibility towards high standards of workers' health protection. Future research has to include investigating the best means of mitigation against airborne infection and the management of post-acute covid sequelae.

COVID-19 Marked a Change in the Scope of Occupational Medicine from Occupational to Work-Related Diseases and Total Worker Health®.

The COVID-19 pandemic challenged occupational medicine, while its focus had already shifted from occupational diseases to work-related illnesses. Such a broader scope allowed the inclusion of transmissible diseases among the causes for concern in working settings. COVID-19 has had a profound impact globally, resulting in millions of infections, often lethal. From its appearance, COVID-19 was found to affect specific groups of workers at higher risk of contracting the virus due to their occupation or workplace conditions, which accounts for its consideration as a potential work-related disease. This overview examines various aspects of COVID-19 based on articles published in our journal. Specifically, the epidemiology of COVID-19 is discussed, including mortality rates and groups at higher risk. The diagnosis, measures to prevent contagion, vaccination efforts, long-term effects, and psychosocial factors are also summarized. The emerging picture is that COVID-19 has been a trigger accelerating the change of paradigm of occupational medicine, which is more and more concerned with prevention. Occupational Health contributes to health promotion and Total Worker Health®.