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| Safety and Health Topics > Small Business Training > The Occupational Health Professional's Services and... | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The Occupational Health Professional's Services and Qualifications: Questions and Answers | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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What Issues Should be Considered in Selecting a Health Care Professional? What Unique Contributions Can an Occupational Health Care Professional Make to Workplace Safety and Health? Who are Qualified Occupational Health Care Professionals? How Can an Employer Verify the Scope of Practice for Health Care Professionals in the Licensing State? What Qualifications Should an Employer Look for in an Occupational Health Care Professional? Is There a Good Way to Evaluate the Qualifications of an Occupational Health Care Professional? What is the Difference Between Occupational Health Care Professionals and Other Occupational Safety and Health Professionals? What OSHA Standards for General Industry Require Screening and Surveillance or Occupational Health Services? Resources Sources of Assistance: American Academy of Occupational Health Nurses (AAOHN) American Board of Industrial Hygiene (ABIH) American College of Occupational and Environmental Medicine (ACOEM) Private Practice Section. American College of Occupational and Environmental Medicine (ACOEM) Board of Certified Safety Professionals (BCSP) Discussion/Overheads - 1.63 MB PDF 
Student Handouts - 204 KB PDF
Controlling occupational injuries and illnesses and related expenditures is a top priority in most companies. Selecting a qualified health care professional to participate in the workplace safety and health activities can be a vital step in this process. The following questions and answers are to provide guidance and serve as a resource for those considering such a selection.
A variety of health care professionals are available to employers. Selecting an appropriate provider for the worksite depends on a number of factors, including:
Qualified occupational health care professionals can assist the employer in achieving a safe and healthy work environment. Along with other safety and health professionals, health care professionals work collaboratively with labor and management to:
Health care professionals are uniquely qualified to assess and treat illnesses and injuries. The health care professional must have appropriate licensure, registration, or certification. Additionally, they should have occupational health experience and expertise in management and be available on a full- or part-time basis, depending on the nature and size of worksite(s). They may be a permanent employee or hired on a contractual basis. Traditionally, these services have been provided by physicians or registered nurses. In addition to working collaboratively with other safety and health professionals, a qualified health care professional may be selected to:
Health care providers such as physician assistants (PAs), licensed practical nurses (LPNs), and emergency medical technicians/paramedics (EMTs) can augment the services of the physician or registered nurse. Although these providers may contribute valuable services, they must be supervised by a physician or a registered nurse. Whatever health care professional is chosen, the employer should ensure that the provider has expertise or experience in occupational health and safety as well as an understanding of occupational illnesses and injuries.
Health care professionals qualified to design, manage, supervise, and deliver health care in occupational settings include a variety of practitioners. It is imperative, however, that the legal "scope of practice" unique to each state be considered prior to hiring or contracting for services. The "scope of practice" refers to the credentials, responsibilities, and limitations of health care practitioners. Physicians and registered nurses, for example, receive standardized educations with core curricula (individualized to their profession) necessary to pass national or state boards and to be licensed in a particular state. They are then eligible to become certified in a specialty practice, such as occupational medicine (physicians) or occupational health nursing (registered nurses), through a combination of additional specific education and experience. The additional educational training in occupational health typically includes course work in epidemiology, toxicology, industrial hygiene, recognition and management of occupational illnesses and injuries, research, and general management of a comprehensive occupational health program. Physicians Medical Doctors: Medical doctors (MDs) have completed 4 years of study at the college level and then 4 years of training at an accredited school. Licensed MDs have passed the National Medical Board Exam or equivalent examinations and have a license to practice within a given state(s). Doctors of Osteopathy: Doctors of osteopathy (DOs) graduate from college and an osteopathic school approved by the American Osteopathic Association. They must pass a state board examination to qualify for a license to practice within a given state(s). Occupational Medicine Physicians: Occupational medicine physicians are medical doctors or doctors of osteopathy who have completed additional occupational medicine training or acquired onsite experience. Completion of additional residency training and further practice in occupational medicine enables physicians to pursue certification in occupational medicine after meeting rigorous qualifying standards and successfully completing an examination in occupational medicine given by the American Board of Preventive Medicine (ABPM). Registered Nurses Registered Nurses: Registered nurses (RNs) receive from 2 to 4 years of training and education at the college level and graduate from a state-approved school of nursing. They pass a state board examination and are granted a license to practice within a given state(s). Occupational Health Nurses: Occupational health nurses (OHNs) are registered nurses with experience and additional education in occupational health. Certified occupational health nurses (COHNs) obtain certification from the American Board for Occupational Health Nurses after meeting rigorous qualifying educational and experience standards and successfully passing an occupational health nursing examination. Nurse Practitioners: Nurse practitioners (NPs) are registered nurses who are licensed in their state and have completed formal advanced education, increasingly at the master's level. In most states, they are certified for advanced practice by the American Nurses Association or specialty nursing organizations. NPs independently perform many health evaluation and care activities, including physical exams, common diagnostic and laboratory tests, and treatment of employees who are ill or injured. They also can prescribe certain medications in most states. Additionally, NPs perform other medical activities using written protocols developed collaboratively with a physician. Physician Assistants Physician Assistants: Physician assistants (PAs) provide services under the direction and supervision of a doctor of medicine or osteopathy. PAs may perform physical examinations, identify health problems, and plan therapeutic interventions. PAs are usually required to complete a 2-year educational program at the bachelor's or master's degree level. Other Health Care Providers Other health care providers include licensed practical or vocational nurses and emergency medical technicians. Traditionally, these individuals are not licensed to practice independently. They have specific training and are usually certified or licensed by the educational institution where they received the training. Sometimes the state licenses or certifies these providers and usually the state's scope of practice outlines the specific work restrictions for these individuals. For example, usually these providers are required to work under the supervision of licensed health care professionals such as MDs, DOs, RNs, and NPs, except when delivering first aid. Licensed Practical/Vocational Nurses: Licensed practical or vocational nurses (LPN/LVNs) graduate from a program of practical nursing and must pass the state board examination. They are licensed by the state to perform certain specific health care activities, under the direct supervision of a physician or registered nurse. Emergency Medical Technicians/Paramedics: Emergency medical technicians (EMTs) are pre-hospital providers trained to provide specific and limited emergency care. Some EMTs receive advanced training to become paramedics. EMTs are authorized to perform their duties by standing orders or protocols from physicians. They respond primarily to injuries and acute illnesses on a temporary basis and are not independently licensed to provide other medical care. Their scope of practice varies greatly from state to state.
Each state has a unique legal description of the scope of practice for health care professionals. When it is necessary to verify a health care professional's scope of practice for the occupational setting, the individual state's licensing or certification board should be contacted, as follows: Medical Doctor State boards of medical examiners and professional licensure can provide information about an occupational physician's educational training and type of practice. The American Board of Medical Specialties (ABMS) publishes an annual list of certified occupational medicine specialists. The employer may refer to the ABMS listings in the reference department of most public libraries. Doctor of Osteopathy Doctors of osteopathy are licensed by a board in each state. Listings may include Board of Medical Examiners, Licensing Examiners, Board of Osteopathic Examiners, Board of Medical Practice, or Medical Licensing Board of (name of particular state). The American Board of Medical Specialties (ABMS) publishes an annual list of certified occupational medicine specialists (See M.D. listing above). Registered Nurse and Nurse Practitioner The state board of nursing in each state is listed in the telephone directory and defines the scope of practice issues for RNs and NPs. The American Nurses Association (ANA) certifies NPs. The American Board for Occupational Health Nurses (ABOHN) certifies RNs in the specialty of occupational health. Physician Assistant The legal scope of practice for PAs varies from state to state. Most states require licensure or certification. PAs are certified by the National Commission on Certification of Physician Assistants (NCCPA). All scope of practice issues for PAs should be addressed to the State Board of Medicine or The NCCPA. Emergency Medical Technician The EMT's scope of practice varies from state to state. There are several practice levels of EMTs each determined by the number of hours of training and the range of procedures authorized. Each state has a director of EMTs listed in the telephone directory under State Government. The appropriate office may be contacted under the telephone directory subheading listed as either the Department of Health, Department of Public Health, or Department of Emergency Medical Services. Licensed Vocational/Practical Nurse The state board of nursing in each state is listed in the telephone directory and defines the scope of practice issues for LVNs/LPNs.
An occupational health care professional evaluates the interactions between employees' work and health in the workplace. To do this effectively, the occupational health care professional should possess the following skills and competencies:
During the interview process, the following kinds of questions and issues are appropriate to evaluate prospective occupational health care professionals:
- Titles of continuing education courses taken in the last 2 years; - Where and when licensed, registered, or certified (ask for documentation); and - Years of experience in occupational health. You should expect the candidate to ask about the following:
- number of employees - work processes - known or potential hazards - application of standards and/or regulations - current method of providing occupational health care services - other health care providers involved in providing services - existence and specifics of a safety and health program - medical surveillance programs - collective bargaining contracts - previous OSHA citations
All occupational health and safety professionals are educated to have a proactive, preventive orientation, with the health and well being of the employee as their primary focus. As mandated by each individual state, however, only health care professionals, within the scope of their practice, can assess and treat illness and injury beyond first aid. Additionally, health care professionals, based upon their education and training, can provide high-quality preventive health care information and programs. The following descriptions highlight the overall skills and areas of competency of other occupational safety and health professionals who might be part of an effective safety and health program at your work site. Industrial Hygiene Industrial hygiene focuses on the identification and control of occupational health hazards arising as a result of or during work. The industrial hygienist focuses on the recognition, evaluation, and control of chemical, biological, or physical factors or stressors arising from the workplace, that may cause sickness, impaired health and well-being, or significant discomfort and inefficiency among workers or in the community. Professional industrial hygienists possess either a baccalaureate or master's degree in engineering, chemistry, biology, physics, or industrial hygiene. The industrial hygienist monitors and uses analytical methods to detect the extent of occupational chemical, biological, or physical exposure and implements engineering controls and work practices to correct, reduce, or eliminate workplace hazards. Industrial hygienists can give expert opinion as to the magnitude of chemical, biological, or physical exposure, and the degree of associated risk. Certified Industrial Hygienists (CIHs) have passed a rigorous qualifying examination. Industrial Engineering Industrial engineering is the design, installation, and improvement of integrated systems of people, material, information, equipment, and energy. Industrial engineering draws upon specialized knowledge and skills in the mathematical, physical, and social sciences, together with principles and methods of engineering analysis and design to specify, predict, and evaluate the results obtained from such systems. The Institute of Industrial Engineers has a special division devoted to ergonomics, and many industrial engineers elect to receive advanced training in this increasingly complex and growing specialty. Safety Professionals Generally, Certified Safety Professionals (CSPs) graduate from accredited college or university programs with a baccalaureate or master's degree in safety and must have at least 4 years of professional safety experience prior to taking the Safety Fundamentals exam. CSPs focus on developing procedures, standards, or systems to achieve the control or reduction of hazards and exposures that would be detrimental to people, property, and/or the environment.
The following OSHA General Industry Standards regulating toxic and hazardous substances have specific medical surveillance requirements in Title 29 Code of Federal Regulations, Part 1910. Copies of OSHA regulations are available at cost from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. Please be advised that this list is subject to revision and expansion. It is the employer's responsibility to know the general and specific OSHA standards that apply to the industry and workplace. General Industry Standards
Some OSHA Standards that require Occupational Health Services
The following resources may be useful for additional information on occupational health care professionals in your area. The associations and colleges are typically the professional organizations for members of the profession. They work to increase awareness of the profession, as well as offer educational, service, and placement benefits for the members. Most have local, state, and/or regional chapters. Boards are generally the certification bodies for occupational health professionals and determine eligibility requirements. They also administer the certification exam and maintain directories of all certified professionals in a particular specialty. All telephone and Fax numbers are accurate as of the date of printing; however, changes can be verified by local telephone directory assistance. _______________ Medical Doctors American College of Occupational and Environmental Medicine 1114 North Arlington Heights Road Arlington Heights, IL 60004 Phone (847) 818-1800 Fax (847) 818-9266 American Board of Preventive Medicine, Inc. 9950 West Lawrence Avenue, Suite 106 Schiller Park, IL 60176 Phone (708) 671-1750 Fax (708) 671-1751 __________________ Osteopathic Doctors American Osteopathic Association 142 E. Ontario Street Chicago, IL 60611 Phone (312) 280-5800 Fax (312) 280-5893 American Osteopathic College of Preventive Medicine 1900 The Exchange, Suite 380 Atlanta, GA 30339 Phone (404) 953-1803 __________________________ Occupational Health Nurses American Association of Occupational Health Nurses 2929 Brandywine Road, Suite 100 Atlanta, GA 30341 Phone (770) 455-7757 Fax (770) 455-7271 American Board for Occupational Health Nurses, Inc. 201 East Ogden Road Suite 114 Hinsdale, IL 60521-3652 Phone (630) 789-5799 Fax (630) 789-8901 _________________ Nurse Practitioners American Academy of Nurse Practitioners P.O. Box 12846 Austin, TX 78711 Phone (515) 442-4262 _________________ Registered Nurses American Nurses Association 600 Maryland Avenue, S.W., Suite 100 Washington, DC 20024 Phone (202) 651-7000 Fax (202) 651-7001 ___________________ Physician Assistants National Commission on Certification of Physician Assistants 6849-B2 Peachtree Dunwoody Road Atlanta, GA 30328 Phone (770) 399-9971 Fax (770) 399-2766 __________________________ Emergency Medical Technicians National Commission on Certification of Physician Assistants P.O. Box 29233 Columbus, OH 43229 Phone (614) 888-4484 Fax (614) 888-8920 ___________________ Industrial Hygienists American Board of Industrial Hygiene 4600 W. Saginaw Street Suite 101 Lansing, MI 48917 Phone (517) 321-2638 __________________ Safety Professionals Board of Certified Safety Professionals of America 208 Burwash Avenue Savory, II 61874-9510 Phone (217) 359-9263 Fax (217) 359-0055 Copies of OSHA regulations are subject to revision and expansion. It is the employer's responsibility to know the general and specific OSHA standards that apply to the industry and workplace. Discussion/Overheads - 1.63 MB PDF
Student Handouts - 204 KB PDF
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