Occupational Health Service

The University recognises that to produce high-quality work requires healthy and well motivated staff. The Occupational Health Service provides comprehensive and competent advice and support to both managers and individuals on how work and the work environment can affect an employee’s health and how an employee’s health can affect their ability to perform well in their role.

We can provide:

• employment screening;
• health surveillance;
• parking permit eligibility advice;
• health referrals;
• rehabilitation plans;
• workplace assessments;
• accident and incident investigation;
• immunisations;
• travel health advice;
• informal health advice;
• policy, guidance and information development;
• an OH service for students.

The service, which is part of the Health and Safety Office, is provided by an occupational health physician (under contract), two occupational health advisors and an administrator. Contact details

Health referrals

The main purpose of management referrals to Occupational Health Service is to support effective and proactive management of staff with health issues impacting on attendance and/or performance at work, with the ultimate aim of helping to keep employees healthy and at work.

An Occupational Health Service referral will provide independent and objective advice to managers to assist them in dealing fairly with employee health issues, whilst balancing the needs of the employee with work requirements.

The assessment and report will provide a clear opinion on

• Fitness for work: whether or not the employee has a health problem that may affect their fitness for work, or issues at work affecting their health.
• Return to work: if the employee is currently absent, when they are likely to be ready to return
• Rehabilitation advice: measures that may enable the employee to return to work before full recovery including temporary adjustments to hours/duties.
• Future attendance: how much absence is likely in future due to health problems and whether the employee fit to undertake all duties?
• If the person is not fit to return to their previous work, the report will outline prospects for re-deployment and/or retirement on medical grounds
• Application of the Disability Discrimination Act 2005

Please note that any recommendations made in an occupational health report for workplace adjustments will be subject to further consideration by managers in terms of what would constitute a reasonable adjustment in each individual case, taking into account factors such as operational requirements and the impact on others.

The assessment also provides the person referred with an opportunity to discuss any health concerns in confidence with an Occupational Health Adviser, and receive advice on what they can do to improve their health and/ or attendance and performance at work.

Guidance for managers on the referral process

Who can refer?

Personnel Managers lead the referral process for members of staff. They are able to refer in cases of identified patterns of short term sickness absence and ongoing long term sickness absence, according to attendance records. Personnel Managers will contact the individual’s line manager before making a referral.

If managers have any concerns regarding their members of staff they should contact the appropriate Personnel Manager who will lead them through the referral process. An Occupational Health Advisor will also be able to provide advice to managers on whether it is appropriate to refer an individual.

When to refer

A member of staff should be referred for an assessment when

• they have had several episodes of short-term absences that cannot be managed locally
• there is concern that they may have work related health problems, or that existing health problems are being aggravated by work duties
• they may have difficulties coping on return after being absent e.g.: following a serious illness or disability
• there may be an underlying health factor contributing to performance issues
• there is long term or continuous sickness absence i.e. longer than four weeks, and
• advice is required about early retirement on health grounds.

What to expect at the appointment – guidance for members of staff

The employee is interviewed by an Occupational Health Advisor about their health and the effects of any health problems on their work and home life. The Advisor may wish to visit the workplace to enable an accurate assessment to be made. The Adviser will also ask about other issues that may affect their health and about any treatment they have received. If necessary the employee can be referred to see the Occupational Health Physician for further advice/assessment. In some instances further supporting medical information will be requested from the employees GP or treating specialist, with their written consent. It may also be necessary to review the employee after a period of time sufficient to assess recovery or response to treatment, before a firm opinion can be given on when an employee is ready to return to work or to full duties.

Health surveillance

Health surveillance can be defined as any activity which involves obtaining information about an employees’ health and which helps protect employees from health risks at work.

The benefits of carrying out health surveillance are:

• To protect employees from illness caused by being exposed to health risks at work, by detecting any adverse health effects at an early stage;
• To enable departments to manage any health risks effectively by providing a check on how existing control measures are working and provide information on whether further measures are needed;
• To enable compliance with legal requirements;
• To provide an opportunity to reinforce key health and safety messages to staff.

Health surveillance is necessary when:

• There is a disease associated with a substance in use, for example asthma or dermatitis;
• It is possible to detect the disease or adverse change and be able to reduce the risk of any further harm to the individual by for example carrying out a lung function test or skin inspection;

Guidance on health surveillance

The first stage of any health surveillance programme is to identify the hazards to health in the workplace through risk assessment. If the hazard cannot be completely controlled and risks remain, further steps need to be taken to protect employees, one of which is to consider health surveillance.

Examples of workplace hazards include:

• noise;
• vibration;
• Solvents, fumes and dusts;
• biological agents;
• animals;
• asbestos;
• ionising radiation.

Once a risk assessment has identified a need for health surveillance managers or school/service safety advisors can refer employees to the Occupational Health Service by completing a health surveillance referral form (doc, 58 Kb).

Following receipt of the referral form employees will be contacted directly by Occupational Health and provided an appointment time. The individual will be contacted within three days of receiving the referral form, and an appointment offered usually within the next seven working days.  If employees have any difficulties attending an appointment they should contact Occupational Health and discuss with an Adviser.

If there are a group of employees from a department requiring the same type of surveillance it may be possible to arrange a site visit. If recalls are required Occupational Health will follow up with individual employees.

Records of health surveillance are maintained by the Occupational Health Service for a minimum period of 40 years. In most cases no adverse health effects are found, however, in some cases further investigations are required to assess any possible adverse ill health effects. Adjustments may be advised to the workplace or for the individual such as further training and/or improved personal protective equipment or transfer to alternative work. Managers will be notified of any unsatisfactory results where actions are required.

Immunisations

Organisations are required to offer immunisations to employees who may be exposed to pathogens at work where an effective vaccine is available. Effective vaccinations are only available for some pathogens. Immunisation is not a substitute for good laboratory or other work practice and is regarded as an additional protective control measure against disease and not as the main defence.

Immunisation will be offered to all employees and student groups who are indicated in a risk assessment to be at risk of an occupationally acquired infection for which a safe and effective vaccine is available. The need for immunisations will be identified from the job hazard form at the pre-employment stage for many posts.

Additional immunisation requirements will be identified by managers and or school/service safety advisors from risk assessments. Once a risk assessment has identified a need for the provision of immunisations managers or school/service safety advisors can refer employees to the Occupational Health Service by completing an immunisation referral form (doc, 61 Kb).

Following receipt of the referral form employees will be contacted directly by Occupational Health and provided an appointment time. The individual will be contacted within three days of receiving the referral form, and an appointment offered usually within the next 7 working days.  If employees have any difficulty relating to attending an appointment they should contact Occupational Health and discuss with an Adviser.

An Occupational Health Advisor will determine the immunisation schedules in accordance with the individual’s immunisation history and their vaccine schedules. All immunisation dates will be held by Occupational Health in the individuals’ confidential health record.

Needlestick injury

The main risk posed by needle-stick injury to employees and students is exposure to blood bourne viruses including Hepatitis B, Hepatitis C and the HIV virus.

In the event of a needlestick injury or contamination incident involving human blood or other body fluids immediate action should be taken as follows:

• Wash the site liberally with soap and water (without scrubbing);
• Encouraged the wound to bleed for puncture wounds, do not suck the site;
• If the needle stick injury is with unscreened blood or blood products or from a known Hepatitis B or HIV patient then immediately contact the Needlestick Hotline available 24 hours a day, every day on 0117 342 3400 (please state location when calling);
• Dispose of any contaminated sharps safely;
• Report the incident immediately to your line manager who will complete an accident report form to be sent to the Health and Safety Office.

Guidance on precautions that should be followed when working with human blood or tissue

Recommendations that will help to prevent a needlestick injury or any blood contamination and risk of exposure to a blood-borne virus are as follows (also see the Biological Safety and Genetic Modification Safety Policy):

• Ensure effective hand washing after contact with blood or body fluids;
• Appropriate PPE (personal protective equipment) should be worn including gloves and protective clothing. Gloves can reduce the risk of transmission of infection, even if the glove is penetrated;
• Eye protection (visors, goggles, or safety spectacles) should be worn when blood, body fluids or flying contaminated debris/tissue might splash into your face;
• Ensure that you cover any cuts or abrasions with waterproof plasters;
• Avoid wearing open footwear;
• Handling of sharps should be kept to a minimum;
• Do not re-sheath needles;
• Dispose of needles and syringes as whole units;
• Dispose of sharps safely into approved, puncture-proof sharps bins immediately after use;
• Sharps containers should be available at the point of use and not overfilled. Over-full bins increase the risk of sharps injury;
• Sharps bins must be locked for disposal and replaced when filled to the indicated line on the outside of the bin.

Night shift work

Under the Working Time Regulations 1998, all night workers must be offered a health assessment by their employer, i.e line manager. The health assessment can be provided by the University Occupational Health Service.

A night worker is classified as an individual who regularly works for more than three hours during the period 11 pm to 6 am. All night workers are offered on a voluntary basis an initial and an annual health assessment which is confidential. This is in addition to any other health assessment undertaken via the University.

If you are a night worker and wish to take up the opportunity of an assessment please complete a night workers health questionnaire (doc, 51Kb) and return it to the Occupational Health Service by post or fax as advised on the form, or as an email attachment sent to bristol-occhealth@bristol.ac.uk.

The questionnaire, which will be processed in the strictest confidence, has been designed to identify possible areas of special need in relation to night work and provide a basis for further detailed assessment. Where necessary, an Occupational Health Advisor will undertake this with you and offer any health advice. Referral for further medical advice may also be appropriate in some cases but this will always be with your consent. Following an assessment, a statement of fitness for night work will be issued to you and to your manager.

Please contact the Occupational Health Service if you have any queries regarding the health assessment.

Tips for staying healthy whilst working on night shifts

Sleep:

• Go to sleep as soon as you can after work, and don't get caught up in other tasks which can be done later in the day.
• If you are exposed to a lot of sunlight right after work, your body will wake up which will make sleep difficult. Make your room as dark as possible with blinds, curtains, or even a sleep mask.
• To keep disturbing noise to a minimum, get a good set of ear plugs. Unplug the phone in your room. Talk to your family members about taking extra care to be quiet.
• Avoid the use of sleeping tablets. They do not help your body clock to adjust, so talk to your doctor before using them. The same  goes for alcohol, which  might make you go to sleep faster, but you will not sleep as soundly.
• Avoid caffeine too close to bedtime as  you will find it hard to fall asleep.

Nutrition:

• Adjust your meal routine around your schedule, and do not skip meals. Plan ahead and bring a healthy meal with you to work.
• Do not eat a huge meal right at the end of your shift. It could lead to trouble digesting, as well as disrupted sleep.
• Fuel up on carbohydrates (for example cereals, rice, pasta etc) which will release energy slowly over a long period of time.
• Drink plenty of water throughout your shift as dehydration can cause cramps and headaches.

Maintaining a healthy work-life balance:

• Exercise can boost your alertness. If you can’t exercise at work during breaks, try to build it into your routine before you start your shift. Do not exercise right after you get home, before going to sleep as it will wake you up.
• Make time around your shifts to continue with hobbies and interests, as this promotes health and well being.
• Spend time with family and friends, and if it is difficult to see them plan times when you can call them at each end of your shift.

Travel health

The Occupational Health Service can offer travel advice and immunisations for staff travelling overseas on work related business.

You need to make an appointment with the Occupational Health Advisor to discuss your travel arrangements and this should be organised well in advance, preferably six to eight weeks prior to departure. Some immunisation schedules may need to be given over a period of time and may take some time to become effective.However please contact the Occupational Health Service even if at short notice as some protection is better than none.

You will need to complete a travel referral questionnaire (doc, 66 Kb) and return it to the Occupational Health Service as an email attachment sent to:bristol-occhealth@bristol.ac.uk or by fax to: 0117 330 2699. We will then contact you to arrange an appointment.

Vaccinations

Specific need for immunisations will depend on where you are staying, how long you are away for and what activities you will be undertaking. The Occupational Health Advisor will advise you appropriately at your appointment.

Malaria

If you are travelling to certain countries you may need to protect yourself against malaria and we can advise on appropriate treatment as well as on mosquito bite avoidance including:

• Being aware of areas where mosquitos are present and also the times at which they are most active; which is especially after sunset. Therefore if you are out at night wear long-sleeved clothing and long trousers.
• Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin. Always follow the manufacturers instructions and advice on usage and suitability.
• Spraying insecticides in the room, burning pyrethroid coils and heating insecticide impregnated tablets can all help to control mosquitoes.
• If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide) is a sensible precaution. Portable, lightweight nets are available from specialist suppliers.
• Garlic, Vitamin B and ultrasound devices do not prevent bites.

Travel health links:

• http://www.fitfortravel.nhs.uk
  Will give you advice on recommended immunisations and malaria prevention in advance of your appointment so that you have some idea of what you may need. This site is very informative and updated regularly.
• http://www.dh.gov.uk
  Health advice for travellers, from the Department of Health’s website, provides useful guidelines on travel health, including how to get treatment overseas.

Workstation assessments

Computer workstations or equipment can be associated with neck, shoulder, back or arm pains, fatigue and eyestrain. These aches and pains are sometimes called upper limb disorders (ULDs) or repetitive strain injuries (RSI). These problems can be avoided by following good practice. ULD’s can also be associated with other work activities or workstations. Examples from a laboratory environment include using a microscope, pipetting or working at a safety cabinet.  The risk factors are how the work is organised and managed, work involving repetitive or forceful action poses a greater risk of causing ULDs.

Display screen equipment (DSE) is any work equipment having a screen that displays information. Surveys have found that high proportions of DSE workers report aches, pains or eye discomfort. Mostly these conditions do not indicate any serious ill health, but it makes sense to avoid them as far as possible.

By law the University is required to identify hazards and assess risks from the workstation and the kind of DSE work being done. Draw valid and reliable conclusions from assessments and identify steps to reduce risks. Each school or service will have trained assessors who are able to undertake this process. The role of the DSE assessors is to ensure that workstations meet the minimum requirements and are set up correctly for all members of staff. The DSE assessor will ensure that the assessments are reviewed on a regular basis.  Further details are outlined in the University's Display Screen Equipment Policy (PDF, 156 Kb).

The role of the Occupational Health Service is to provide specialist expertise to members of staff who are experiencing detrimental health effects and/or provide advice to DSE assessors to help them in their role.

Referral process for workstation assessments

An individual with a health issue that is related to their workstation may ask their line manager or their DSE assessor to refer them to the Occupational Health Service for an assessment. Before you can be referred a workstation assessment needs to have been completed by your school/service safety advisor or your DSE assessor.

An Occupational Health Advisor on receipt of a workstation referral form (doc, 54 Kb) will contact the person to arrange a consultation.  This may take place within Occupational Health Services at Hampton House or at the individual’s workplace if necessary.

The consultation will seek to establish the history of the condition and current symptoms. The Advisor will be able to offer assistance in making any necessary adjustments to the workstation. This may include recommendations to use specialist ergonomic equipment such as a vertical mouse or a mini keyboard.  The Health and Safety office is able to provide equipment for loan to members of staff, further information on the equipment available is contained in the Ergonomic Equipment Loan Arrangements guidance document (PDF, 390 Kb).

Following the consultation a management report will be written usually within three working days of the assessment. The report is provided to both the individual member of staff and the line manager. It is the responsibility of the line manager to action any recommendations.

Referral to the University Occupational Health Physician is an option that may be used for any complex conditions where a further medical opinion is required.