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The purposes of occupational medicine are described in terms of its clinical medical, environmental medical, research, and administrative content. Each of these components is essential in different proportions in comprehensive occupational health services for different industries, and can only be satisfactorily provided by occupational physicians and occupational health nurses who are an integral part of their organizations. Two-thirds of the working population in the United Kingdom are without the benefits of occupational medicine. The reorganization of the National Health Service and of local government presents the opportunity to extend occupational health services to many more workers who need them. It is suggested that area health authorities should provide occupational health services for all National Health Service staff and, on an agency basis, for local government and associated services, eventually extending to local industry. Such area health authority based services, merged with the Employment Medical Advisory Service, could conveniently then be part of the National Health Service, as recommended by the British Medical Association, the Society of Occupational Medicine, and the Medical Services Review Committee.

Family physicians are naturally concerned with the work effects or causes of their patients' health problems. As occupational risk factors have become better understood, however, a new specialty of occupational medicine has been recognized by the Royal College of Physicians and Surgeons in 1984, two years after the Canadian Board of Occupational Medicine started its own certification. Occupational physicians are available to act as an extension of the family doctor's care and can provide trustworthy medical resources in the workplace. The family physician should be aware of some of the games poorly trained or ill-informed personnel managers may play in the workplace if they have no medical consultant to rely on. New human rights legislation has given more opportunities to rehabilitate workers back to their jobs, and occupational physicians and family physicians can achieve a great deal in co-operation as a result.

Lee, W. R. (1973).British Journal of Industrial Medicine,30, 118-124. Emergence of occupational medicine in Victorian times. The events surrounding the establishment and development of legislation to protect the health of people at work in Victorian times are already well documented. This paper deals with some other aspects of the development of occupational medicine.

The earliest recorded occupational health service in this country was that established in a cotton spinning factory at Quarry Bank Mill in Cheshire. The mill was built in 1784 by Samuel Greg and his partners. They employed local labour and also some parish apprentices. Happily, Samuel Greg was a good christian and, having created a modern factory and a model village with a church and a school, he was equally concerned for the physical welfare of his employees. Accordingly, he appointed a doctor to make pre-employment examinations of the apprentices and to visit regularly to deal with the health problems of a community of some 400 people. The man he chose was Peter Holland of Sandlebridge, who had served his medical apprenticeship under Dr Charles White of Manchester. The first record of the employment of a doctor was in 1796, but from 1804 to 1845 (doubtless in response to the early factory legislation) each visit of the doctor was entered in a day book with either an indication of fitness to work or details of the treatment required. The complete record consists of two hardback foolscap notebooks that provide a fascinating insight into the medical practice of the times when the industrial revolution was just getting under way. One of the more interesting features is the preservation of medical secrecy. Dr Holland made his comments on the case in shorthand and his instructions in longhand. By a fortunate coincidence the key to the shorthand was discovered and this has now been largely transcribed. Although much of the content of the diaries is the day by day practice of medicine at the time, there are many illuminating glimpses of the early practice of occupational medicine.

Over the last century, environmental and occupational medicine has played a significant role in the protection and improvement of public health. However, scientific integrity in this field has been increasingly threatened by pressure from some industries and governments. For example, it has been reported that the tobacco industry manipulated eminent scientists to legitimise their industrial positions, irresponsibly distorted risk and deliberately subverted scientific processes, and influenced many organisations in receipt of tobacco funding. Many environmental whistleblowers were sued and encountered numerous personal attacks. In some countries, scientific findings have been suppressed and distorted, and scientific advisory committees manipulated for political purposes by government agencies. How to respond to these threats is an important challenge for environmental and occupational medicine professionals and their societies. The authors recommend that professional organisations adopt a code of ethics that requires openness from public health professionals; that they not undertake research or use data where they do not have freedom to publish their results if these data have public health implications; that they disclose all possible conflicts; that the veracity of their research results should not be compromised; and that their research independence be protected through professional and legal support. The authors furthermore recommend that research funding for public health not be directly from the industry to the researcher. An independent, intermediate funding scheme should be established to ensure that there is no pressure to analyse data and publish results in bad faith. Such a funding system should also provide equal competition for funds and selection of the best proposals according to standard scientific criteria.

Leistungsfähigkeit ist für viele Berufsgruppen von elementarer Bedeutung für die Bewältigung der täglichen Arbeitsanforderungen (u. a. Feuerwehr, Polizei, Militär, aber auch Beschäftigte im Baugewerbe, Bergbau und Landwirtschaft). Für die Überprüfung der körperlichen Leistungsfähigkeit steht dem Arbeits- und Betriebsmediziner die (Fahrrad-)Ergometrie als standardisierte, unter Praxisbedingungen durchführbare Untersuchung zur Verfügung. Unter Berücksichtigung der nationalen und internationalen Leitlinien und aktueller wissenschaftlicher Literatur werden die für den Arbeitsmediziner notwendigen Kenntnisse, Voraussetzungen, Indikationen und Kontraindikationen der Ergometrie zusammengefasst. Durchführungsempfehlungen werden dargestellt. Abbruchkriterien aufgrund pathologischer Auffälligkeiten oder bei Erreichen der Ausbelastung werden aufgelistet.Die Vor- und Nachteile der Stufenvs. der Rampenbelastung werden gezeigt. Neben den physiologisch zu erwartenden Reaktionen bei dieser Belastungsprüfung wird auch die eingeschränkte Sensitivität und Spezifität der Ergometrie für die Diagnostik einer koronaren Herzerkrankung am Beispiel der falsch-positiven und falsch-negativen Ergometrieuntersuchungen für Männer und Frauen im Alter von 50–59 Jahren mit unklaren Brustbeschwerden diskutiert.Die unterschiedlichen Ergometrieformen und ihre teilweise eingeschränkte Vergleichbarkeit untereinander und mit den reellen Arbeitsbedingungen erschweren darüber hinaus die Aussagekraft der Fahrradergometrie für die Beurteilung der körperlichen Leistungsfähigkeit eines Probanden, da lediglich die spezifisch fahrradergometrische Leistungsfähigkeit geprüft wird. Trotz den bei gesunden und jungen Probanden geringen Komplikationsraten sollte daher der Einsatz der Fahrradergometrie in der arbeitsmedizinischen Vorsorge kein Automatismus bei der Beurteilbarkeit der körperlichen Leistungsfähigkeit für den Einsatz des Probanden an einem bestimmten Arbeitsplatz sein. ; A sufficiently high level of physical performance is of elementary importance for ...

This article presents the circumstances of the birth of occupational medicine in the interwar period in Poland. The first regulations concerning preventive examinations of young employees were created on the basis of the Act of July 2, 1924, concerning the work of minors and women. This act imposed an obligation on business entities to carry out free medical examinations for minors as ordered by the labor inspector. The first examination of underage employees was carried out in 1926. However, compliance with the laws and orders of the labor inspectorate during the interwar period left much to be desired. There was a shortage of doctors in the labor inspectorate, and a shortage of specialized medics to carry out the examinations. Despite the difficulties, the period in question saw the successful introduction of compulsory medical examinations for young workers. In 1930, 16,121 underage employees were diagnosed in this way. The interwar years also saw the first initiatives resulting from an increased awareness of preventive care for adult workers.

The Institute of Occupational Medicine (IOM) was founded in 1969 by the then UK National Coal Board to complete its nation-wide epidemiological study of lung disease in coal miners, the Pneumoconiosis Field Research. The results quantified risks in the industry and were influential across the world in setting preventive standards. The research, based on epidemiology, was multidisciplinary from the start, and the IOM's broad scientific expertise was applied across many other industries with an increasing focus on environmental measurement and ergonomics. In 1990, as the coal industry declined, IOM became a self-funding research charity with a strong commercial arm. It has expanded its research, often with European collaborators and funding from governments, and has achieved wide recognition. This has most recently been applied during the pandemic in areas of hospital ventilation, personal protection, and viral exposure research, illustrating IOM's ability to respond to new environmental or occupational challenges.