Healthy Employees: Using Occupational Medicine to Insure a Healthier Workforce

by: Dr. Keith Holder

Healthy employees make healthy businesses

Occupational health is an area of preventive medicine that is concerned with the whole person and how that person’s health may respond to the work environment. An occupational health practitioner is concerned with the patient’s health history as well as how the work environment affects that specific individual’s health.

For example, extreme temperature exposures can drastically impact the health of a person suffering from hypertension or diabetes. This can pose a problem, especially during the summer months. In this instance, the goal is to educate the worker in the possible side-effects of the higher temperatures and to offer possible solutions that could help prevent a heat related illness.

Summer heat

Here at Cooper Clinic, we see several heat related injuries each week during the summer months.  The majority of these patients have an underlying health condition, such as hypertension and diabetes, that has not been recognized or treated effectively.  When an energy drink is added to these conditions, the stage is set for a heat related illness.

Heat related illnesses might be treated as simply as a few days in a cool environment or to several days in the hospital with dialysis for kidney failure.   A few instances of heat related deaths are believed to be preventable.  Through education, occupational health can prevent a large worker population from being affected.  Education takes place as we work closely with the safety representatives at our client companies to help prevent injuries and illnesses from occurring.

Exposure to temperature extremes, lifting of heavy weights in an unsafe manner, or the misuse of power equipment are just a few of the hazards occupational health practitioners evaluate. Biological and chemical exposures are other areas of concern. Occupational health evaluations become more complex in a company where workers are exposed to multiple health hazards.


Through evaluations, administrative procedures can be put into place that provide “stay times” to prevent heat exposure. Or, engineering reductions and eliminations of noise hazards are generally more effective than personal protective equipment–such as the wearing of hearing protection or respirators. While practitioner evaluations and administrative procedures can prevent illness or injuries, cooperation on the part of the worker is also a necessary element of the safe work environment.

A recurring discussion involves bearded workers whose job requires the wearing of a respirator. For the safety of the worker, a clean shave can be requested  before the respirator fit test. This allows determination of the worker’s level of protection without the beard. Respirator physical exams also provide an opportunity to assess the worker’s breathing and general health.

It is not uncommon for workers wearing respirators to be working in protective clothing.  The additional clothing adds to the heat load experiences of the worker.  If this worker also has uncontrolled diabetes or hypertension while wearing a respirator and protective clothing, then the stage is set for at least a heat related illness or worse.  Educating management and workers about these issues of general health is indicated, both at work and in recreational activities outside work.

The practice of occupational medicine is rewarding when individuals succeed in changing health patterns that affect their health.  Being able to change health patterns for whole populations at a company or community can be challenging, but it is highly rewarding for all participants.

Plan of action

Health fairs can help identify an existing condition, but the follow through after the fair is when progress begins. At the fair, certain medical conditions of a number of employees can be identified. The real questions are answered, however, in the cycle of evaluations after the fair.

Doing health screenings, using health fairs or health risk appraisals, should be the last element of any responsible wellness program.  A detailed plan of action of what to do for the employees identified with a medical condition needs to be in place before any screening activity.  Constant monitoring of the medical conditions helps to document improvements.  If the plan of action is not working then the plan needs to change.

Different employees need different levels of support and coaching in order to achieve their goals.  Recognizing natural coaches in fellow employees will help individuals make the necessary behavioral health changes.  Occupational health providers can be facilitators for this change.  We are uniquely positioned as mediators between the business and medical communities.  Occupational health practitioners speak both languages and have an understanding of both environments.

For more information or to find out how occupational health can benefit your organization visit


Dr. Holder joined Cooper Clinic in 1997 and established the Occupational Medicine Department. A graduate of the University of Arkansas School of Medical Sciences, Little Rock, he completed his Occupational Medicine residency at Uniformed Services University of the Health Sciences, Bethesda, MD. Dr. Holder is Board Certified by the American Board of Preventive Medicine specializing in Occupational Medicine.

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