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Overcoming Diagnostic Issues and Training

Program for Doctors in Hong Kong and

China

Dr. Ignatius YuClinical Professor and Head,

Division of Occupational and Environmental Health

Associate Director (Research), School of Public Health and Primary Care

The Chinese University of Hong Kong

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WORKAND

HEALTH

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Occupational Medicine

The effects of work on healthThe effects of health on workA clinical specialty

Dealing with individual patientsA specialty in preventive medicine (public health)

Dealing with groups of working people

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Prescribed Occupational Diseases in Hong KongCompensation Legislation

Employees’ Compensation Ordinance (48)Pneumoconiosis Compensation Ordinance (3)Occupational Deafness Compensation Ordinance (1)

Preventive Legislation Occupational Safety and Health Ordinance - Notification of Occupational Diseases

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DiagnosisEmployees’ Compensation Ordinance

The process for confirming the diagnosis of occupational disease is unclear

Pneumoconiosis Compensation OrdinanceDiagnosis and assessment by a designated Pneumoconiosis Medical Board with specialists in occupational medicine and respiratory medicine

Occupational Deafness Compensation OrdinanceDiagnosis and assessment by a statutory Occupational Deafness Medical Committee with representatives from all related disciplines (Occupational Medicine, ENT, Audiology)Designated hearing test centers for medical examination and hearing assessment

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Occupational Physicians

Medical specialists in Occupational MedicineMedical practitioners trained in Occupational Medicine but have not achieved specialist statusMedical practitioners offering medical services to companies and factories but without formal training in OM

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3 Levels of Formal Training

Diploma in Occupational Medicine

Master in Occupational Medicine

Specialist in Occupational Medicine

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Specialist in Occupational Medicine

Hong Kong Academy of MedicineHong Kong College of Community Medicine

Occupational Medicine Subspecialty Board3 years basic trainingan academic course with the taught component in occupational medicine/ occupational health equivalent to that of a master coursePart I Examination (8 hours of written examination)3 years higher specialist trainingPart II Examination

Written Papers (6 hours)Practical/Clinical Examination (5 stations)

Part III (Exit) Examination

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Occupational Physicians in Hong Kong

Currently, there are only about 20 fully qualified occupational physicians in Hong Kong (most are in universities and the government) but unfortunately, not all of them are actively involved in occupational health programs for various reasons.

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Occupational Physicians in Hong Kongthe missing block

most occupational safety and health programs at company level are without any input from occupational physicians

company doctors/'contract doctors' curative treatment, pre-employment examinations (to screen out

unfit applicants), controlling sick leave may not have received training in OM

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Value-Adding Contributions From Occupational PhysiciansAt the territory-wide level, advice on

appropriate legislation and policy health information systems for occupational accidents and diseases (with their skills in epidemiology and biostatistics)strategies and the practical aspects of dealing with major occupational and environmental incidents

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Value-Adding Contributions From Occupational PhysiciansAt the company level,

the engagement of an occupational physician will enable the company to adopt a more pro-active approach than the current one that places too much emphasis on screening out unfit workers and on curative treatment. a comprehensive occupational health program may benefit from the contributions from an occupational physician

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What Are We Doing in Hong Kong

treatmentplacement

maintenanceprevention

protection

promotion

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Where Do We StandWhere Should We Stand

protect workers healthprevent diseases and injuriespromoting occupational health good health is good business good matching improves production

efficiency and leads to better physical and mental health

Division of Occupational and Environmental Health

Thank you for your kind attention!

Hope you have enough food for thought …