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Çalışma Hayatında İşe Uygunluk Değerlendirmesi

Yıl 2021, Cilt: 2 Sayı: 69, 1147 - 1162, 01.01.2021

Öz

İşe uygunluk değerlendirmesi, işyeri hekimleri İYH başta olmak üzere çalışma hayatı ile ilgilenen hekimlerin önemli bir sorunudur. Kronik hastalıklarda, iş kazaları ve meslek hastalıkları tanısı sonrasında, gebelik gibi fizyolojik durumlarda çalışanın yeni durumuyla çalışma şekline uyumu ve uygunluğunu değerlendirmek gereklidir. Bu değerlendirmeler sonrasında çoğu kez çalışma ortamında değişiklikler ve düzenlemeler yapmak ve geri dönen çalışan için çalışana özel sağlık izlemi planlamak gerekir. Konu ile ilgili ulusal rehber dokümanların olmayışı ve diğer alan uzmanlarının iş sağlığı ve güvenliği İSG ile ilgili bilgi ve farkındalık düzeylerinin çoğunlukla yetersiz olması sorunu daha da büyütmektedir. İyi uygulama örneklerinde ya işe uygunluk konusunda yetişmiş özel bir insan gücünün ya da çoğunlukla birden çok disiplinin bir arada çalıştığı bir referans merkezin değerlendirme sürecini yönettiği görülmektedir. Türkiye’de, iş ve meslek hastalıkları uzmanlığı İMHU 2012 yılında kurulmuş yeni bir uzmanlık alanıdır. Halen çok az sayıda uzman meslek hastalıkları tanısı, çalışanların sağlığının korunması ve geliştirilmesi alanlarında çalışmaktadır. İMHU alanı için önemli etkinliklerden birisi de işe uygunluk değerlendirmeleridir. İMHU işe uygunluk değerlendirmelerinde sahada İYH başta olmak üzere iş sağlığı profesyonellerinin ihtiyaç duyduğu iş-sağlık ilişkisini kurmak üzerine eğitim almış uzmanlardır. Çalışanın tıbbi izlemi ve çalışma ortamına yönelik öneriler konusunda karar verirken klinik bilgilerini işyeri ortamı faktörleri ile birlikte değerlendirebilmektedir. Bu derlemede işe uygunluk konusunun; iş ve meslek hastalıkları bilim alanı uzmanı gözüyle, ülke örnekleri, örnek bir olgu ve öneriler üzerinden tartışılması amaçlanmıştır

Kaynakça

  • Ağır ve Tehlikeli İşler Yönetmeliği (Yürürlükten Kaldırılan) (16.06.2004). Resmi Gazete sayı:25494.https://www.ttb.org.tr/mevzuat/index.php?option=com_content& view=article&id=207:ar-ve-tehleller-yetmel&catid=2:ymelik&Itemid=33 (24.09.2020)
  • Anema, J. R., Jettinghoff, K., Houtman, I., Schoemaker, C. G., Buijs, P. C., ve Van Den Berg, R. (2006). Medical Care of Employees Long-Term Sick Listed Due to Mental Health Problems: A Cohort Study to Describe and Compare the Care of the Occupational Physician and the General Practitioner. Journal of Occupational Rehabilitation, 16(1), 41–52. https://doi.org/10.1007/s10926- 005-9001-4
  • Beatty, J. (2018). Chronic Illness Stigma and Its Relevance in the Workplace. Içinde: Thomson S., Grandy G. (ed) Stigmas, Work and Organizations (pp. 35–54). New York: Palgrave Macmillan. https://doi.org/10.1057/978-1-137-56476-4_3
  • Beyan, C., Demiral, A. ve Erdal, Y. (2020). Stigma toward Worker with Occupational Diseases: A Qualitative Study. Anatol J Family Med, 3(1), 31–39. https://doi.org/10.5505/anatoljfm.2019.14633
  • Bilir N. (2016). İş Sağlığı ve Güvenliği (1. edisyon). Ankara: Güneş Tıp Kitabevi.
  • Black, D. C. (2012). Completion of the Statement of Fitness for Work. Clinical Medicine, Journal of the Royal College of Physicians of London, 12(1), 7–8. https://doi.org/10.7861/clinmedicine.12-1-7
  • BOHS (2020). Guidance for Members and nonHealthcare Businesses. https://www.bohs.org/wp-content/uploads/2020/07/Return-To-WorkGuide-July-2020-min.pdf (28.09.2020)
  • Byng, R., Wheat, H. ve Barnes, R. K. (2015). Fit for work?: How GPS’ Decisions About Fitness to Work Can İmprove Health. British Journal of General Practice, 65(636), 338–339). https://doi.org/10.3399/bjgp15X685549
  • Canadian Human Rights Commission (2007). A Guide for Managing the Return to Work. https://www.chrc-ccdp.gc.ca/eng/content/guide-managing-returnwork (28.09.2020)
  • Coggon, D. ve Palmer, K. T. (2010). Assessing Fitness for Work and Writing a “fit note” Europe PMC Funders Group. BMJ, 26. www.icmje.org/coi_disclosure.pdf
  • ILO (1996). Recording and Notification of Occupational Accidents and Diseases. https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--- safework/documents/normativeinstrument/wcms_107800.pdf (08.06.2020)
  • ILO (1998). Technical and Ethical Guidelines for Workers’ Health Surveillance. https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--- safework/documents/normativeinstrument/wcms_177384.pdf (24.09.2020)
  • IPIECA ve IOGP (2011). Fitness to work: Guidance for company and contractor health, HSE and HR professionals. OGP Report No. 470. London. https://www.ipieca.org/resources/good-practice/fitness-to-work/
  • İş Sağlığı ve Güvenliği Kanunu (30.06.2012). Resmi Gazete sayı: 28339. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.6331.pdf (24.09.2020)
  • İş ve Meslek Hastalıkları Uzmanları Derneği, http://imud.org.tr/BULTEN.html
  • İşyeri Hekimi ve Diğer Sağlık Personelinin Görev, Yetki, Sorumluluk ve Eğitimleri Hakkında Yönetmelik (20.07.2013). Resmi Gazete sayı: 28713. https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=18615&MevzuatTur=7& MevzuatTertip=5 (24.09.2020)
  • Karadağ, Ö.K. (Haziran 2017). Yüksekte Çalışma [Sunu slaytı]. Yüksekte Çalışma Çalıştayı. Ankara. https://docplayer.biz.tr/53326486-Yuksekte-calisma-haziran2017-ankara-dr-ozkan-kaan-karadag-md-is-sagligi-bilim-uzmani-msc-kamuyonetimi-bilim-uzmani-msc.html (01.09.2020)
  • Kişisel Verilerin Korunması Kanunu (07.04.2016). Resmi Gazete sayı: 29677. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.6698.pdf (24.09.2020)
  • Knauf, M. T. ve Schultz, I. Z. (2016). Current Conceptual Models of Return to Work. İçinde: Handbook of Return to Work (pp. 27–51). New York, Springer. https://doi.org/10.1007/978-1-4899-7627-7_2
  • L Alessio, L. D. C. (2004). Collaboration Between the Cardiologist and the Occupational Health Physician Needed for Formulating the Etiological Diagnosis and the Job Fitness Evaluation. Med Lav, 95(2), 98–103. https://pubmed.ncbi.nlm.nih.gov/15218740/
  • Lorenzo D, Metrio D, Francesco G. ve Pirris A, G. M. (1999). Criteria and modalities of Assessment of Work Fitness for Jobs in Food İndustry. Med Lav, 90, 473– 483. https://pubmed.ncbi.nlm.nih.gov/10434529/
  • McNamara, R. J., McKeough, Z. J., McKenzie, D. K. ve Alison, J. A. (2014). Physical Comorbidities Affect Physical Activity in Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study. Respirology, 19(6), 866–872. https://doi.org/10.1111/resp.12325
  • Müller, M. J. (2008). Occupational Health Physician. Netherlands, Springer (pp. 1028– 1029). https://doi.org/10.1007/978-1-4020-5614-7_2401 (25.09.2020)
  • Nemarnik, R. E. ve Macan, J. (2018). Employment Status of Workers with a Diagnosed Occupational Disease in Croatia: A 10-year trend (2005-2014). Arhiv Za Higijenu Rada i Toksikologiju, 69(3), 220–225. https://doi.org/10.2478/aiht-2018-69-3132
  • Noh, S. R. (2010). Availability of the 6-min Walk Test in Coal Workers’ Pneumoconiosis Evaluations. Chest (Vol. 137, Issue 6, pp. 1492–1493). https://doi.org/10.1378/chest.10-0070
  • OSHA (2015a). Fit2work: Austria. https://osha.europa.eu/en/publications/austriafit2work/view
  • OSHA (2015b). The Danish National Return-To-Work Programme: Denmark. https://osha.europa.eu/en/publications/denmark-danish-national-return-work programme/view
  • OSHA, https://www.osha.gov/safetypays, 2020.
  • Peckham, T. K., Baker, M. G., Camp, J. E., Kaufman, J. D. ve Seixas, N. S. (2017). Creating a Future for Occupational Health. 61(1), 3–15. https://doi.org/10.1093/annweh/wxw011
  • Preisser, A. M., Zhou, L., Garrido, M. V. ve Harth, V. (2016). Measured by the Oxygen Uptake in the Field, the Work of refuse Collectors is Particularly Hard Work: Are the Limit Values for Physical Endurance Workload Too Low? International Archives of Occupational and Environmental Health, 89(2), 211–220. https://doi.org/10.1007/s00420-015-1064-8
  • Schultz, I. Z., Chlebak, C. M. ve Stewart, A. M. (2016). Impairment, Disability, and Return to Work (pp. 3–25). https://doi.org/10.1007/978-1-4899-7627-7_1
  • Serra, C., Rodriguez, M. C., Delclos, G. L., Plana, M., Gómez López, L. I. ve Benavides, F. G. (2007). Criteria and Methods Used for the Assessment of Fitness For Work: A Systematic Review. In Occupational and Environmental Medicine (Vol. 64, Issue 5, pp. 304–312). BMJ Publishing Group. https://doi.org/10.1136/oem.2006.029397
  • Soleo, L., Romano, C. ve Apostoli, P. (2006). Fitness For Work: The SIMLII Health Surveillance Guidelines. Medicina Del Lavoro, 97(3), 491–500.
  • Şimşek C. (2019). IMUD Bülten (1). http://imud.org.tr/BULTEN.html
  • T.C. Anayasası (09.11.1982). Resmi Gazete sayı: 17863. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.2709.pdf (24.09.2020)
  • T.C. Cumhurbaşkanlığı Mevzuat Bilgi Sistemi, 2020, https://www.mevzuat.gov.tr/
  • Türk Kardiyoloji Derneği Ulusal Hipertansiyon Tedavi ve Tanı Reh beri, 1999. https://tkd.org.tr/kilavuz/k03.htm
  • TUKMOS, İş ve Meslek Hastalıkları Uzmanlık Eğitim Müfredatı, 2018.
  • UK Parliament. The 1833 Factory Act. https://www.parliament.uk/about/livingheritage/transformingsociety/livinglearning/19thcentury/overview/factoryact/ (24.09.2020)
  • Young, A. E., Wasiak, R., Roessler, R. T., McPherson, K. M., Anema, J. R. ve Van Poppel, M. N. M. (2005). Return-to-work Outcomes Following Work Disability: Stakeholder Motivations, Interests and Concerns. Journal of Occupational Rehabilitation, 15(4), 543–556. https://doi.org/10.1007/s10926- 005-8033-0

Assessing fitness to work in working life

Yıl 2021, Cilt: 2 Sayı: 69, 1147 - 1162, 01.01.2021

Öz

The assessment of fitness for work is an important problem of all physicians who are interested in working life, but especially workplace doctors. In chronic diseases, after the diagnosis of occupational accidents and occupational diseases and in physiological situations such as pregnancy, it is necessary to evaluate the adaptation and fitness of the workers to the new situation and the working style. After these evaluations, it may be necessary to make changes and arrangements in the working environment and the working style. Health monitoring should be planned specific to the worker for their return to work. Lack of national guidelines and documents on the subject and the field experts’ insufficient knowledge and awareness on occupational health are important limitations. In the examples of good practice, either a special human source trained in fitness for the job or a reference center where more than one discipline works together manages the process. Occupational medicine specialization is a new specialty in Turkey that have been established in 2012. Currently, very few specialists work in the field of occupational disease diagnosis and protection and promotion of workers’ health. One of the most important activities in occupational diseases field is fitness for work assessments. Occupational medicine specialists are experts who are trained to establish the work and health relationship required by occupational health professionals, especially the workplace doctors in the field of fitness for work. They evaluate their medical knowledge and workplace environment factors together while making decisions about workers’ medical follow-up and recommendations for the work environment. In this review, the concept of fitness for work is aimed to be discussed from the perspective of an occupational medicine expert, through country examples, a sample case and recommendations

Kaynakça

  • Ağır ve Tehlikeli İşler Yönetmeliği (Yürürlükten Kaldırılan) (16.06.2004). Resmi Gazete sayı:25494.https://www.ttb.org.tr/mevzuat/index.php?option=com_content& view=article&id=207:ar-ve-tehleller-yetmel&catid=2:ymelik&Itemid=33 (24.09.2020)
  • Anema, J. R., Jettinghoff, K., Houtman, I., Schoemaker, C. G., Buijs, P. C., ve Van Den Berg, R. (2006). Medical Care of Employees Long-Term Sick Listed Due to Mental Health Problems: A Cohort Study to Describe and Compare the Care of the Occupational Physician and the General Practitioner. Journal of Occupational Rehabilitation, 16(1), 41–52. https://doi.org/10.1007/s10926- 005-9001-4
  • Beatty, J. (2018). Chronic Illness Stigma and Its Relevance in the Workplace. Içinde: Thomson S., Grandy G. (ed) Stigmas, Work and Organizations (pp. 35–54). New York: Palgrave Macmillan. https://doi.org/10.1057/978-1-137-56476-4_3
  • Beyan, C., Demiral, A. ve Erdal, Y. (2020). Stigma toward Worker with Occupational Diseases: A Qualitative Study. Anatol J Family Med, 3(1), 31–39. https://doi.org/10.5505/anatoljfm.2019.14633
  • Bilir N. (2016). İş Sağlığı ve Güvenliği (1. edisyon). Ankara: Güneş Tıp Kitabevi.
  • Black, D. C. (2012). Completion of the Statement of Fitness for Work. Clinical Medicine, Journal of the Royal College of Physicians of London, 12(1), 7–8. https://doi.org/10.7861/clinmedicine.12-1-7
  • BOHS (2020). Guidance for Members and nonHealthcare Businesses. https://www.bohs.org/wp-content/uploads/2020/07/Return-To-WorkGuide-July-2020-min.pdf (28.09.2020)
  • Byng, R., Wheat, H. ve Barnes, R. K. (2015). Fit for work?: How GPS’ Decisions About Fitness to Work Can İmprove Health. British Journal of General Practice, 65(636), 338–339). https://doi.org/10.3399/bjgp15X685549
  • Canadian Human Rights Commission (2007). A Guide for Managing the Return to Work. https://www.chrc-ccdp.gc.ca/eng/content/guide-managing-returnwork (28.09.2020)
  • Coggon, D. ve Palmer, K. T. (2010). Assessing Fitness for Work and Writing a “fit note” Europe PMC Funders Group. BMJ, 26. www.icmje.org/coi_disclosure.pdf
  • ILO (1996). Recording and Notification of Occupational Accidents and Diseases. https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--- safework/documents/normativeinstrument/wcms_107800.pdf (08.06.2020)
  • ILO (1998). Technical and Ethical Guidelines for Workers’ Health Surveillance. https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--- safework/documents/normativeinstrument/wcms_177384.pdf (24.09.2020)
  • IPIECA ve IOGP (2011). Fitness to work: Guidance for company and contractor health, HSE and HR professionals. OGP Report No. 470. London. https://www.ipieca.org/resources/good-practice/fitness-to-work/
  • İş Sağlığı ve Güvenliği Kanunu (30.06.2012). Resmi Gazete sayı: 28339. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.6331.pdf (24.09.2020)
  • İş ve Meslek Hastalıkları Uzmanları Derneği, http://imud.org.tr/BULTEN.html
  • İşyeri Hekimi ve Diğer Sağlık Personelinin Görev, Yetki, Sorumluluk ve Eğitimleri Hakkında Yönetmelik (20.07.2013). Resmi Gazete sayı: 28713. https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=18615&MevzuatTur=7& MevzuatTertip=5 (24.09.2020)
  • Karadağ, Ö.K. (Haziran 2017). Yüksekte Çalışma [Sunu slaytı]. Yüksekte Çalışma Çalıştayı. Ankara. https://docplayer.biz.tr/53326486-Yuksekte-calisma-haziran2017-ankara-dr-ozkan-kaan-karadag-md-is-sagligi-bilim-uzmani-msc-kamuyonetimi-bilim-uzmani-msc.html (01.09.2020)
  • Kişisel Verilerin Korunması Kanunu (07.04.2016). Resmi Gazete sayı: 29677. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.6698.pdf (24.09.2020)
  • Knauf, M. T. ve Schultz, I. Z. (2016). Current Conceptual Models of Return to Work. İçinde: Handbook of Return to Work (pp. 27–51). New York, Springer. https://doi.org/10.1007/978-1-4899-7627-7_2
  • L Alessio, L. D. C. (2004). Collaboration Between the Cardiologist and the Occupational Health Physician Needed for Formulating the Etiological Diagnosis and the Job Fitness Evaluation. Med Lav, 95(2), 98–103. https://pubmed.ncbi.nlm.nih.gov/15218740/
  • Lorenzo D, Metrio D, Francesco G. ve Pirris A, G. M. (1999). Criteria and modalities of Assessment of Work Fitness for Jobs in Food İndustry. Med Lav, 90, 473– 483. https://pubmed.ncbi.nlm.nih.gov/10434529/
  • McNamara, R. J., McKeough, Z. J., McKenzie, D. K. ve Alison, J. A. (2014). Physical Comorbidities Affect Physical Activity in Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study. Respirology, 19(6), 866–872. https://doi.org/10.1111/resp.12325
  • Müller, M. J. (2008). Occupational Health Physician. Netherlands, Springer (pp. 1028– 1029). https://doi.org/10.1007/978-1-4020-5614-7_2401 (25.09.2020)
  • Nemarnik, R. E. ve Macan, J. (2018). Employment Status of Workers with a Diagnosed Occupational Disease in Croatia: A 10-year trend (2005-2014). Arhiv Za Higijenu Rada i Toksikologiju, 69(3), 220–225. https://doi.org/10.2478/aiht-2018-69-3132
  • Noh, S. R. (2010). Availability of the 6-min Walk Test in Coal Workers’ Pneumoconiosis Evaluations. Chest (Vol. 137, Issue 6, pp. 1492–1493). https://doi.org/10.1378/chest.10-0070
  • OSHA (2015a). Fit2work: Austria. https://osha.europa.eu/en/publications/austriafit2work/view
  • OSHA (2015b). The Danish National Return-To-Work Programme: Denmark. https://osha.europa.eu/en/publications/denmark-danish-national-return-work programme/view
  • OSHA, https://www.osha.gov/safetypays, 2020.
  • Peckham, T. K., Baker, M. G., Camp, J. E., Kaufman, J. D. ve Seixas, N. S. (2017). Creating a Future for Occupational Health. 61(1), 3–15. https://doi.org/10.1093/annweh/wxw011
  • Preisser, A. M., Zhou, L., Garrido, M. V. ve Harth, V. (2016). Measured by the Oxygen Uptake in the Field, the Work of refuse Collectors is Particularly Hard Work: Are the Limit Values for Physical Endurance Workload Too Low? International Archives of Occupational and Environmental Health, 89(2), 211–220. https://doi.org/10.1007/s00420-015-1064-8
  • Schultz, I. Z., Chlebak, C. M. ve Stewart, A. M. (2016). Impairment, Disability, and Return to Work (pp. 3–25). https://doi.org/10.1007/978-1-4899-7627-7_1
  • Serra, C., Rodriguez, M. C., Delclos, G. L., Plana, M., Gómez López, L. I. ve Benavides, F. G. (2007). Criteria and Methods Used for the Assessment of Fitness For Work: A Systematic Review. In Occupational and Environmental Medicine (Vol. 64, Issue 5, pp. 304–312). BMJ Publishing Group. https://doi.org/10.1136/oem.2006.029397
  • Soleo, L., Romano, C. ve Apostoli, P. (2006). Fitness For Work: The SIMLII Health Surveillance Guidelines. Medicina Del Lavoro, 97(3), 491–500.
  • Şimşek C. (2019). IMUD Bülten (1). http://imud.org.tr/BULTEN.html
  • T.C. Anayasası (09.11.1982). Resmi Gazete sayı: 17863. https://www.mevzuat.gov.tr/MevzuatMetin/1.5.2709.pdf (24.09.2020)
  • T.C. Cumhurbaşkanlığı Mevzuat Bilgi Sistemi, 2020, https://www.mevzuat.gov.tr/
  • Türk Kardiyoloji Derneği Ulusal Hipertansiyon Tedavi ve Tanı Reh beri, 1999. https://tkd.org.tr/kilavuz/k03.htm
  • TUKMOS, İş ve Meslek Hastalıkları Uzmanlık Eğitim Müfredatı, 2018.
  • UK Parliament. The 1833 Factory Act. https://www.parliament.uk/about/livingheritage/transformingsociety/livinglearning/19thcentury/overview/factoryact/ (24.09.2020)
  • Young, A. E., Wasiak, R., Roessler, R. T., McPherson, K. M., Anema, J. R. ve Van Poppel, M. N. M. (2005). Return-to-work Outcomes Following Work Disability: Stakeholder Motivations, Interests and Concerns. Journal of Occupational Rehabilitation, 15(4), 543–556. https://doi.org/10.1007/s10926- 005-8033-0
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Ayşe Çoşkun Beyan Bu kişi benim

Hande Bahadır Bu kişi benim

Duygu Lüleci Bu kişi benim

Arif H. Çımrın Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 2 Sayı: 69

Kaynak Göster

APA Çoşkun Beyan, A., Bahadır, H., Lüleci, D., Çımrın, A. H. (2021). Çalışma Hayatında İşe Uygunluk Değerlendirmesi. Çalışma Ve Toplum, 2(69), 1147-1162. https://doi.org/10.54752/ct.1155146
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