A general framework for assessing fitness for work

Keith T. Palmer and I an Brown

This book on fitness for work gathers together specialist advice on the medical aspects of employment and the majority of medical conditions likely to be encountered in the working population. Though personnel managers and others will find it of great help, it is primarily written for doctors so that family practitioners, hospital consultants, and occupational physicians, as well as other doctors and occupational health nurses, can best advise managers and others who may need to know how a patient’s illness might affect their work. Although decisions on return to work or on placement must depend on many factors, it is hoped that this book, which combines best current clinical and occupational health practice, will be used by doctors and others as a source of reference and remind them about the occupational implications of illness.

It must be emphasized that, apart from relieving suffering and prolonging life, the objective of much medical treatment in working-aged adults is to return the patient to work. Much of the benefit of modern medical technology and the skills of physicians and surgeons will have been wasted if patients who have been successfully treated are denied work, through ignorance or prejudice, by employers or doctors acting on their behalf. A main aim of this book is to remove the excuse for denying work to those who have overcome injury and disease and deserve to be employed.

The book is arranged in chapters according to specialty or topic, most chapters having been written jointly by two specialists, one of whom is an occupational physician. For each specialty the chapter outlines the conditions covered; notes relevant statistics; discusses clinical aspects, including treatment, which affect work capacity; notes rehabilitation requirements or special needs at the workplace; discusses problems that may arise at work and necessary work restrictions; notes any current advisory or statutory medical standards; and makes recommendations on employment aspects of the conditions covered.

The first five chapters are applicable to any condition. This introductory chapter deals mainly with the principles underlying medical assessment of fitness for work, contacts between medical practitioners and the workplace, and confidentiality of medical information. Chapter 2 covers legal aspects, Chapter 3 focuses on the Equality Act, Chapter 4 outlines the current provision for support, rehabilitation, and restoring fitness for work, and important ethical principles of occupational health practice are elaborated in Chapter 5 (which is written by the Chair of the Faculty of Occupational Medicine’s Ethics Committee).

A chapter on the possible effects of medication on work performance and additional chapters on the ageing worker, sickness absence, ill health retirement, health screening, health promotion in the workplace, return to work following critical illness, working with cancer, and fitness to drive are also included. Appendices on medical standards in various specific settings (civil aviation, merchant shipping, offshore work diving, work overseas) complete the book.

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