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Online information and learning materials on OSH,
state-of-the-art & challenges
em. prof. Frank van Dijk
Foundation Learning and Developing Occupational Health, LDOH &
Coronel Institute of Occupational Health AMC, Amsterdam, The Netherlands
Mount Sinai Hospital NYC, January 2015
F.J.H. van Dijk, J.H. Verbeek, J.L. Hoving,
C.T. J. Hulshof. Knowledge Infrastructure for
Occupational Safety and Health.
JOEM 2010; 52: 1262-1268.
Version 19-1-2015 def
• The subject
• Examples of OSH knowledge translation practice
• Challenges
Coronel Institute
Solvents in paint,
cleaners, cutting
oil, etc.
Narcotic gasses
Cytostatic drugs,
chemotherapeutics
Pesticides
Heavy metals
Other chemical
substances
Coronel Institute
2007
When I studied and wrote my PhD thesis (1966-1984)
Everything has changed...
and will change much more
for: professionals, workers and managers
CREATION OF
Scientific articles, books
CREATION OF
TLV’s, measurement protocols,
professional (national) publications
OPs & OHNs and
Safety experts
WORKERS
MANAGERS
COMPANIES
Govt, Social Security
STORAGE AND
ACCESS VIA
Libraries
EDUCATION
AND TRAINING,
CONGRESSES,
MEETINGS
Knowledge
translation from
science to practice
in the past
CREATION OF
Scientific articles, (books),
REVIEWS
CREATION OF
TLV’s, measurement protocols,
professional (national) publications,
GUIDELINES, Q&A’s, APPS,
QUALITY WEBSITES,
SEARCH TOOLS, ONLINE COURSES
& LESSONS, WIKIPEDIA, YouTube
OSH AND OTHER
PROFESSIONALS
WORKERS
MANAGERS
COMPANIES
Govt, Social Security
STORAGE AND
ACCESS VIA
VIRTUAL LIBRARIES,
REPOSITORIES,
CLEARING HOUSES
EDUCATION
AND TRAINING,
CONGRESSES,
MEETINGS
Knowledge
translation from
science to practice
today
Knowledge translation to practice changed
ICT opportunities (access) >>>
Knowledge / number of articles >>>
Half-life of knowledge <<
Role of evidence >>
Education of workers/management >>
Liability (USA, Europe) > ?
Examples of new knowledge translation practices
Professionals
• Evidence-based guidelines
• Reviews
• Search tools
Diverse target groups
• Online learning materials
• Websites
• Apps
• Wikipedia
• YouTube
• Q&A
Evidence-
based
guidelines
14
Reviews
OSH
search
strings
for
PubMed
Filters for OSH interventions
Link to PubMed with most sensitive search for retrieving studies of occupational health interventions
(effect*[tw] OR control[tw] OR controls*[tw] OR controla*[tw] OR controle*[tw] OR controli*[tw] OR controll*[tw] OR evaluation*[tw] OR program*[tw]) AND (work[tw] OR works*[tw] OR work'*[tw] OR worka*[tw] OR worke*[tw] OR workg*[tw] OR worki*[tw] OR workl*[tw] OR workp*[tw] OR occupation*[tw] OR prevention*[tw] OR protect*[tw])
Link to PubMed with most specific search strategy for retrieving studies
of occupational health interventions
(program[tw] OR "prevention and control"[sh]) AND (occupational [tw] OR worker*[tw])
etiology of occupational diseases just the Mesh term ‘occupational diseases’ e.g. after a name for a specific disease.
Or: follow Schaafsma F, Hulshof C, de Boer A, van Dijk F. Effectiveness and efficiency of a literature search strategy to answer questions on the etiology of occupational diseases: a controlled trial. Int Arch Occup Environ Health. 2007; 80: 239-47.(not free)
suspected occupational or work-related diseases Mattioli S, Zanardi F, Baldasseroni A, et al. Search strings for the study of putative occupational determinants of disease. Occup Environ Med. 2010 ;67:436-43. (free article)
agricultural workers’ diseases Mattioli S, Gori D, Di Gregori V, et al. PubMed search strings for the study of agricultural workers' diseases. Am J Ind Med. 2013; 56: 1473-81 (not free)
chronic diseases and work Haafkens J, Moerman C, Schuring M, van Dijk F. Searching bibliographic databases for literature on chronic disease and work participation. Occup Med (Lond). 2006; 56: 39-45 (free)
return to work studies Gehanno JF, Rollin L, Le Jean T, Louvel A, Darmoni S, Shaw W. Precision and recall of search strategies for identifying studies on return-to-work in Medline. J Occup Rehabil. 2009; 19: 223-30 (not free)
primary health care ("Primary Health Care"[Mesh] OR "General Practitioners"[Mesh]) OR "Physicians, Family"[Mesh] OR "Physicians, Primary Care"[Mesh] OR "Nurse Practitioners"[Mesh] OR "Community Health Workers"[Mesh]) from: P. Buijs and F van Dijk report for WHO, 2014 (free)
work disability PM ("Rehabilitation, Vocational"[Mesh] OR "Sick Leave"[Mesh] OR absenteeism[MeSH Terms] OR "workers’compensation"[MeSH Terms] OR "work status" OR "work capacity" OR "return to work" OR "work disability" OR employment[MeSH Terms] OR work[MeSH Terms] OR insurance medicine[TW] OR sickness absence[TW]) (filter with good specificity; lower sensitivity)
Online OSH
courses and
lessons for
professionals
http://www.workershealtheducation.org
600 subscribers on the Newsletter Plan to start an active network of educational institutes and experts using the Forum function Problem: financial resources and institutional commitments
Coronel Institute
Interactive online e-course to introduce and educate BOHS: seven modules, glossary, references
Examples of lessons and short courses
• Carcinogenic substances Canada
• Making the occupational link UK
• Musculoskeletal disorder awareness UK
• WIND video (agriculture) ILO
• Practicing personal protection PAHO (WHO Americas)
• Asbestos UK
• Biological hazards in health care USA
• Occupational asthma UK
• Fitness for work and rehabilitation UK
• Evidence-base practice The Netherlands
http://www.dokterhoe.nl/
Copied
from
Max
Lum
NIOSH
Apps
Wikipedia
Methylene chloride
YouTube
YouTube Metrics August 2013 February 2013 Change
Exposure Accounts 1 1 0%
Exposure Videos posted 101 82 23%
Influence Action
Follower-Who Views-downloads
169,229
138,578
22%
Outcomes Surveys, stories
Outcomes Evaluation studies Campaigns
From Max Lum, NIOSH
Do workers / managers have OSH questions?
100%
71% Yes
29% No
42% Yes
58% No
Workers, managers
with OSH questions
seeking OSH information
Rhebergen et al. 2011; Survey Dutch Workers N=888. CCOHS, 2008
Questions
and
Answers
online
Q&A
Sources used for OSH information or advice
0 5 10 15 20 25 30 35 40 45 50 55 60
Experts in law and regulations
Experts from sector or occupational associations
Experts from trade unions
Social media or internet fora
Other sources of information or advice
Magazins, journals, fact sheets, brochures, books, etc.
Specific pre-known websites
Experts in regural health care
Experts in occupational health service
Social or professional network (e.g. family, friends, peers)
In-company OSH-related experts
Websites found trough Google
% of total respondents who searched for OSH
information or advice
Rhebergen et al 2011
Expert network ArboAntwoord, 80 highly-qualified OSH experts,
many disciplines
Online OSH expert network
• No problem with distances, 24/7, many
disciplines, efficient, cheap
• Easy knowledge retrieval e.g. OSH Answers
• When interactive:
– elaboration of questions using telephone/Skype, WhatsApp chatting, sending photo or measurement by smartphone
• Disadvantages: no physical examination, no workplace visit, less personal contact
Rhebergen et al., 2010; Harper et al., 2008; CCOHS, 2008, Iske, 2005
Whether it is a health or safety question about the work you
do, the CCOHS team is dedicated to answering any questions
you may have.
By Internet or telephone
Canadian Centre for Occupational
Health and Safety www.ccohs.ca
Challenges
• We have seen inspiring products and practices improving
knowledge to practice!
• What are good tools for a better quality of care and
workers/company practice?
• Examples for profesionals: e-b guidelines and learning materials
• Examples for workers/managers: websites and apps
Criteria for a good quality products or care
provided by high quality experts
a good process of making a product or giving care/service
high quality of outputs
optimal impact on professionals, workers and companies
{Criteria for ‘good’ workers and managers}
{educated, informed, motivated, empowered}
Criteria for good products or care
Input high level experts developing materials, providing care
Process AGREE criteria for developing e-b guidelines
developed in international collaboration
Output coverage of all relevant topics
good quality : valid, up-to-date
tailor-made for target group (content, language)
accessible: not expensive; easy to find, also using Google or Wikipedia
Outcome exposure, users
influence or induced action
final outcomes (knowledge, health, safety, work participation)
Professional guidelines, The Netherlands/UK
high level experts developing materials ++
AGREE process developing e-b guidelines +
international collaboration 0
all relevant topics covered 0
valid ++ (new ones)
up-to-date +
tailor-made for target group (content, language) ++ for profs
not expensive or free +++
easy to find, also through Google/Wikipedia ?
exposure (=reach?) ++
influence or action +
final outcomes + ?
from
+++
to
- - -
Learning materials for professionals, global
high level experts developing materials ++
AGREE type process quality ?
international collaboration 0
all relevant topics covered +
valid ?
up-to-date +
tailor-made for target group (content, language) ++
not expensive or free ++
easy to find, also through Google/Wikipedia - -
exposure - -
influence or action + ?
final outcomes + ? (patient level?)
Websites and apps for workers & managers
high level experts developing materials ++
AGREE type process quality ?
international collaboration -
all relevant topics covered -
valid +
up-to-date +
tailor-made for target group (content, language) +
not expensive or free; ++
easy to find, also through Google/Wikipedia -
exposure ?
influence or action ?
final outcomes ?
Examples of good international collaboration
– Reviews and search strings: • Cochrane OSH Review working group
• PEROSH, 12 OSH institutes Europe: OSH evidence SR database
– Guidelines: UK – Netherlands
– Learning materials: • www.workershealtheducation.org
• WHO collaborating centres
– Wikipedia: NIOSH separately from EU Agency Bilbao?
But: Often local prevails above national, regional or global
Almost no funded programs! ICOH ? WHO ? ISSA ? WONCA ?
Questions
• Who is taking responsibility, is leading, funding?
• What can WE do?
Should we
o join the e-health movement, integration?
o start an evaluation task force?
o start OSH platforms for exchange?
ouse ICOH and/or WHO for program funding?
o shift attention from professionals to workers/managers?
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