Asbestos is a mineral which naturally occurs in rock, soil and sediment. The fibres generally are heat resistant, have insulating properties, are very light and are not visible to the human eye.


Asbestos becomes a health risk when its fibres become airborne and are breathed in. The risk increases with the number of fibres inhaled. Asbestos exposure can lead to serious diseases that develop over decades such as Asbestosis, Lung cancer, Pleural disorders and Mesothelioma.


Even though Asbestos mining and importation have been banned in Australia, it is still found in fibro, pipes, flue, drains, roofs, gutters, brakes, gaskets and clutches products manufactured prior to this ban. The key industries that Asbestos is known to affect are:


  • Construction and Demolition
  • Telecommunications
  • Utilities such as Water and Electricity
  • Plumbing
  • Mechanical Services

There are three typical cases that may present to Injurynet:


  1. Organisational Awareness of potential Exposure. When an organisation has been alerted that a worker may have been exposed to Asbestos. In this case Health Monitoring may be required.
  2. Incident Exposure. When an unexpected exposure incident occurs. A Baseline Test (the first episode of Health Monitoring) may be recommended.
  3. Worker Diagnosis. When a worker has been diagnosed with a condition (such as Asbestosis) case management by an occupational doctor may be helpful.

Injurynet offers an end to end health monitoring service for the medical management of Asbestos. This end to end medical management service includes a tailored approach to managing the potential health effects of Asbestos following a potential exposure or incident, as well as supporting an employee who has been diagnosed with an Asbestos-related condition. In the majority of cases our process includes the following:


  1. Design of the Program using a risk-based approach
  2. Education of all stakeholders.
  3. Implementation of the Program Coordination of testing at our network of clinics including an examination by a doctor, chest x-ray (to ILO standard) and spirometry. Testing (other than x-rays) can also be provided onsite.
  4. Ongoing Monitoring Our in house occupational doctor review all of the information from the testing, compare results with previous findings and determine if any follow up is required. Employers and employees are kept updated on the health monitoring, its outcomes and the next steps throughout the process.

For more information about our Asbestos Health Monitoring service, please contact us on 1300 574 040 or support@injurynet.com.au


References:
  1. Department of Health
  2. Safe Work Australia
  3. Better Health Channel
  4. Asbestos in Victoria
  5. Asbestos Diseases Society of Australia

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In Victoria, workplaces are now required to identify close contacts among staff and visitors, collect their details and tell them that they are close contacts. This change will target those at risk, encourage early testing and quickly isolate people. However, this is a new and challenging area for many organisations.


Contact tracing requires a close understanding of the virus infectivity and transmission dynamics to both protect workers and prevent needless quarantining. Different activities increase the chance of transmission, such as noisy close work environments, workplaces with poor ventilation and when employees spend significant time in the same room.


There needs to be detailed questioning of contact type and duration, and the social settings of those involved.


It is easy to over-estimate the risk and isolate too many staff members leading to sustainability issues for the organisation. Just as importantly, failing to isolate those who need it can have serious ramifications for spread within a workplace.


Injurynet’s medical advisors are able to support organisations to navigate and manage these situations to keep your workplace safe and to reduce the harm COVID-19 can have on your workplace, your employees and local communities.


Our medical advisors can make recommendations on whether groups of contacts should be sent home to isolate, should be tested or can actually stay at work. Subsequently, we can provide specialist advice on release from isolation and safely returning to work.


Advice is also available on possible mitigation strategies to prevent these organisational challenges.


If you would like further information about our COVID-19 medical advisory services, contact Injurynet on 1300 574 040 or support@injurynet.com.au


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By Dr David Milecki and Professor Paul Van Buynder
There has been a lot of discussion about industries screening asymptomatic staff for COVID-19. In Victoria, the government has mandated some high-risk workplaces to regularly test their employees.


What is happening?


In a media release, the Victoria Premier recently announced the commencement of industry-based routine testing for COVID stating:


“ All medium and large employers in the meat, poultry, seafood processing and supermarket and refrigerated distribution sectors will be asked to ensure that a quarter of their workforces are tested each week. This applies to all workers operating from their work premises – and will lead to the majority of a workforce being tested over the course of a month.”1


Implementation is to commence immediately with staff tested at existing facilities or tested on-site by appointment for remote and rural businesses. Asymptomatic persons are not required to isolate after testing.


In addition, it is anticipated that the existing testing programs in place in some hospitals will increase soon to also include regular testing for staff in all aged care and many other health settings.


Why?


Industry-based COVID-19 screening is being introduced to monitor areas associated with high transmission in the past.


In the past, screening with an invasive and somewhat expensive test for a low incidence condition would not meet standard guidelines for the introduction of a screening program.


The standard PCR test in use has high sensitivity and specificity when used at the right time in the course of an illness with SARS-CoV-2 but, as cases fall, this proposed program may lead to an increase in the number of false positives and negatives.


Where are we going?


Ultimately, the search is on for a rapid test that gives answers in minutes and preferably with saliva or a finger prick test that is minimally invasive. These tests are largely based on the detection of viral antigens. Many of these tests are already available and press releases abound from researchers and companies extolling the virtues of their particular process.


A recent position statement from the Royal College of Pathologists in Australia2 has advised that these rapid antigen tests should not be used in Australia because of their relatively low sensitivity and the chance that they would lead to cases being missed and hide the true spread of infection.


The Public Health Laboratory Network (PHLN) & the Communicable Diseases Network of Australia (CDNA) also have a joint group starting to look at these technologies, but not yet at any specific tests. It is likely they will advise against general use diagnostically because of performance limits, but their use under expert supervision in specific public health settings would be supported.


Antigen tests are being used by the World Health Organisation to improve testing access in low/middle-income countries and, one of the tests, marketed by Quidel, is planned for a roll out in the US, a high incidence country.


Antigen tests have clear public health use in cluster settings to encourage large numbers of potential contacts of the case to be tested quickly before they also spread disease.


Four of these tests have been licensed by the Australian Therapeutic Goods Association although none are yet available. The Quidel test looks the best of those available on the sensitivity scale for SARS-CoV-2 with a documented 96.7% sensitivity and 100% specificity. Trials continue in Australia with this product including in aged care settings. These tests will become available for purchase soon in Australia.


Quidel is also working on dual influenza + COVID-19 test which they expect to register in Australia shortly.


In addition to the above trials and use of antigen tests, the Victorian Infectious Disease Laboratory is developing a saliva test which looks promising. The end game of this program is technology transfer to other diagnostic labs to do workplace surveillance testing at scale.


What do industries do now?


Organisations required by Government policy to test staff should continue to use available testing sites utilising nasal swabs and PCR tests. They will need to develop a mechanism for linking testing results to worker attendance, as their program rolls out.


Organisations contacted by companies offering programs with COVID-19 antigen testing kits should resist purchasing these while awaiting further information about the test quality and updated statements from specialty groups involved in verification processes.


Injurynet Medical Advisors can support companies with plans to integrate this testing into their COVID-19 recovery plan and mechanisms for linking testing results to worker attendance.


If you would like further information about our COVID-19 Medical Advisory Service, contact Injurynet on 1300 574 040 or support@injurynet.com.au.


References:
  1. Surveillance Testing Keeping our Community Safe
  2. Royal College of Pathologists of Australasia Position Statement COVID-19 Antigent and Point of Care Testing

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Over the past year, Injurynet partnered with Comcare and three Australian Public Sector agencies to deliver an early intervention service pilot program. All results from the pilot were independently evaluated by Deloittes and have recently been published by Comcare.


The Aims for the Early Intervention Service Pilot were:


To test whether the delivery of a structured and independent early intervention services provided:


  • early access to treatment support services
  • self-management where clinically appropriate
  • enhanced ability, and support to recover at and return to work

The Program was implemented by:


This pilot program implemented our 24/7 nurse triage and injury management service for employees who sustained an injury/illness at work or developed symptoms that impacted their ability to work, regardless of the cause.


The program included direct access to physiotherapy and psychology services in addition to medical services with our network of practitioners around Australia.


It focused on delivering services to employees immediately as soon as they were injured or ill at work.


The Key Findings for the Early Intervention Service Pilot were:


The pilot results demonstrated significant improvements to recovery at and return to work and a positive cost-benefit for employers. Other results include:


  • 93% of the participants triaged to GP’s were certified fit for work
  • Participants had less time off work to recover compared to the control group
  • 2X the recovery rate compared to the control group
  • 93-97% of employees with physical injury and 85% of employees with a psychological injury managed their condition using only the services provided under the pilot.

For more information about this topic, visit the Comcare website


For further information about our early intervention and injury management programs, contact Injurynet on 1300 574 040 or support@injurynet.com.au


References:
  1. The Australian Government Comcare Early intervention service pilot research project (2020)

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Having access to an effective workplace injury management program, where a strong focus is on supporting injured and ill employees to recover at, and return to work quickly, safely and durably is vital in managing the health and wellbeing of staff. It is also important for businesses to manage risks associated with injured and ill employees, including absenteeism, reduced productivity and workers compensation premiums. Effective injury management programs include:


  • Early Intervention,
  • A focus on recovery at and return to work,
  • Open communication, and
  • Appropriate certification by practitioners.

Early intervention is one of the key components of an effective workplace injury management program. Essentially, early intervention needs to occur immediately as soon as an employee is injured or ill at work. This is based on the clear evidence that:


  • Good work is beneficial to people’s health and wellbeing, and that long-term work absence, work disability, and unemployment generally have a negative impact on health and wellbeing1, and that,
  • Time is of the essence – as the likelihood of returning to work diminishes over time2.

Why is early intervention important?


Following a workplace injury or illness, employees need to feel cared about and supported by their workplace during the recovery process. This increases the likelihood of a positive outcome for all parties.


The absence of support by the workplace and a lack of support to access healthcare services can result in an injured or ill employee feeling unsupported and isolated and can lead to a prolonged work absences and have a negative impact on recovery, health and wellbeing.


Why is recovery at work/return to work important?


When a worker is injured or ill at work, it doesn’t always mean they need time off work. Research suggests that recovery at work is an important part of the rehabilitation process and effective injury management programs focus on supporting employees to stay at work.


Some of the benefits of staying at work or returning to work as soon as possible for ill or injured employees include:


  • Improvement in general health and wellbeing
  • A reduction psychological distress
  • Improved recovery outcomes and reduced impact of an injury on an individual’s health and wellbeing

Some of the benefits of staying at work or returning to work as soon as possible for employers include:


  • Improves staff morale
  • Increases workforce participation and productivity
  • Decreases absenteeism and early retirement
  • Improves recovery outcomes and reduces the potential of workers’ compensation premium increases.

Getting back to work is an important step in recovering from a work-related injury and means a worker can return to a normal life, often reducing the financial and emotional impact on them and their family. Returning to work may mean a worker has gone back to their old job or another job and could involve working reduced hours or performing different suitable duties.


Why is communication important?


Effective communication and teamwork between the injured or ill employee, workplace and practitioner(s) are critical in improving outcomes.


Communication should ideally take place between all parties at the initial consultation, and if there is any significant change in status throughout the treatment.


A lack of communication can result in the injured or ill employee and workplace not being clear on the recommendations or support required to provide suitable recovery at work or return to work arrangements, potentially resulting in a prolonged return to work and negative impact on physical and psychological health.


What is appropriate certification?


When an injury occurs, the first step in the return to work process is the issuing of a certificate of capacity, usually by a General Practitioner (GP).


To certify appropriately and consistently based on the clinical assessment, the GP should determine what the injured worker can do (e.g. lift up to 5 kg) and what they can’t do (e.g. reach forward). Knowledge of pathology can also indicate what they shouldn’t do (e.g. reach overhead for a rotator cuff shoulder strain).


It’s easier to manage recovery or return work when specific restrictions are noted, rather than specific duties. As an example, it is better to state “no repetitive forward bending” rather than “admin duties only”. This assists the employer in better finding suitable duties that match the GP’s recommended restrictions.


When a certificate of capacity is issued by the GP, there are several features that should be avoided:


  • Illegible information or unknown abbreviations
  • Restrictions that are driven by the injured or ill employees, such as specific tasks, hours or shifts. These do not usually reflect medically necessary restrictions.
  • Prolonged work restrictions with no progress. It would be reasonable to expect that in most cases, there would be progress in function as the condition improves.

If the GP doesn’t provide appropriate certification it is reasonable to discuss these principles.


In summary, effective injury management programs include early intervention, a focus on recovery at and return to work, open communication and appropriate certification.


If you would like further information about our injury management programs, or to discuss the particular circumstances in your workplace please contact Injurynet on 1300 574 040 or support@injurynet.com.au.


References:
  1. The Australasian Faculty of Occupational and Environmental Medicine (AFOEM) Australian and New Zealand Consensus Statement on the Health Benefits of Work (2011)
  2. Johnson and Fry, Factors Affecting Return to Work After Injury: A study for the Victorian WorkCover Authority (2002)

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A pre-employment medical assessment is an important tool to help manage workplace risk. Pre-employment medical assessments evaluate the health risks relating to the proposed employment and ensure that the potential employee will be able to meet the physical and mental demands of the job.


In many industries, pre-employment medical assessments are a high priority for the long term health and safety of the business. According to Safe Work Australia, the transportation industry, have the highest number of work fatalities due to fatigue, long work hours, role requirement to stay alert and remain calm in stressful situations. A pre-employment medical assessment in this industry can help an employer make an informed assessment about the employee’s suitability for a role ultimately mitigating risks on the road for workers and those that share the roads with them.


Continue reading to learn more about pre-employment medical assessments, examples of high-risk industries and how pre-employment medical assessments reviewed by a doctor can determine an employees’ suitability for a role, prevent the risk of lost productivity, reduce absenteeism and reduce potential exposure to workers compensation claims.


What is a pre-employment medical assessment (PEM)?


A pre-employment medical is any type of medical assessment completed by a doctor before a decision on employment being made. The information obtained from the assessment is considered as one piece of information along with all the other information obtained in the recruitment process.


The medical assessment will typically include a medical history, an examination and special tests including most commonly hearing, lung function, vision, drug and alcohol testing.


Why do pre-employment medicals?


The broad objectives of doing pre-employment medical assessments are to:


  • identify whether the candidate is medically fit to perform the inherent requirements of the proposed role,
  • identify whether placing the candidate in the proposed role poses a material risk of aggravating a health condition and compromising the candidate’s health and safety or the health and safety of others, and to
  • obtain a baseline on the candidate’s health before they commence employment.

Additionally, other testing such as drug and alcohol testing will identify those candidates who may have issues committing to the employers' policy and culture.


Another reason for performing a pre-employment medical assessment is when they are required for compliance with specific industry standards or legislation, such as commercial driver, coal board or rail medical assessments.


What are the benefits of pre-employment medical assessments?


Pre-employment medical assessments are a tool for understanding the workforce as they first enter the workplace. Pre-employment medical assessments can potentially identify those who would be placed at risk of injury or aggravating a physical or mental health condition by undertaking the role and estimate the level of that risk. They are extremely important as a baseline for health surveillance so that any pre-existing health issues can be shown to have pre-dated employment, thereby preventing the employer inadvertently becoming responsible for any pre-existing deficits or conditions.


Pre-employment medical assessments also can assist to:


  • Increase health and safety standards in the business
  • Lower absenteeism and the risk of lost productivity
  • Reduce exposure to workers compensation claims

What tests should be included in a pre-employment medical assessment?


In most circumstances the essential parts of a pre-employment medical assessment are the same as the tools that are used in medicine; that is a good history of the candidate’s medical conditions (past and present) as well as obtaining a good understanding of the impact that those conditions and their treatment have had and continue to have on the candidate. Traditionally, an overview of the history is obtained via a questionnaire that covers all key areas, including mental health. This is followed by a general medical examination focusing on potential issues identified via the history.


All other components of the assessment should be determined by the risks in the proposed role. If there is a risk of hearing damage due to loud noise in the work environment it is essential to obtain a baseline reading of the candidate’s hearing. Without an appropriate baseline, employers can become liable for causing all of the hearing loss an employee identified later, even if much of it is pre-existing. Similarly, if the role involves work with respiratory hazards, such as silica, isocyanates or smoke, and requires the employee to wear a respirator, then the role would be difficult with a significant lung disorder. In these cases, spirometry is required to obtain a baseline and to determine whether the candidate would be able to safely perform the duties. The same thinking applies to all other testings.


How does working in industries such as transport and aged care impact on what testing is performed?


As mentioned above, the testing performed should match the risks associated with the duties to be performed.


In the transport industry, drivers of commercial vehicles require testing that ensures that the candidate meets the national Austroads “Assessing Fitness to Drive” standards. For this to be assessed fully an audiometry test is recommended. The benefit of further musculoskeletal assessment of the candidate should depend on the level of manual handling and physical effort required in the role. For roles that include a significant amount of lifting and carrying or that include opening and closing of heavy truck curtains, a more detailed musculoskeletal assessment with strength and endurance components can be performed.


In aged care, there is a high risk of injury due to work with people who may be losing their physical and mental capabilities. Working in aged care has one of the highest injury rates, with high physical and mental demands. Workers assisting the elderly with their mobility and self-care are often exposed to uncontrollable human weight, lifting, pushing, pulling, repetitive movement and bending which can cause strain to their back, sprains and even bone breaks in some instances. With a high risk of injury, a baseline of physical health such as musculoskeletal testing is recommended depending on the degree of manual handling and physical endurance is required in the role. The pre-employment medical may also cover that of mental health assessment due to the workers' exposure to mental stress and strain caused by grief of loss for those in the employee care, managing relationships and even physical and verbal abuse from the elderly.


How do organisations interpret the medical information obtained by pre-employment medical assessments and the associated testing?


Some organisations have trained and experienced internal staff that can assess the medical information. Some workplaces have occupational health nurses who can interpret the information provided and relate to the specific proposed role. In recent years, there is fewer of these internal medically trained staff available. I have found over the years that having an independent party with medical expertise to interpret the information provides a more standardised and informed approach. The variety and complexity of medical conditions and their potential impact on work mean that workplaces benefit from expert independent medical advice in assessing candidates.


Is there value in drug and alcohol testing at the pre-employment medical and what form of testing is recommended?


Again the decision of whether to perform this testing depends on the risks inherent in the role would be significantly adversely affected by a candidate with an undeclared drug or alcohol problem. For example, identifying a commercial driver who is a regular user of amphetamines or drinks alcohol to unhealthy levels is key information in the transport industry or where close attention to the task could harm the potential employee, other co-workers, the general public or plant and equipment.


There are various choices of types of tests available. At the pre-employment medical stage for drugs, it is beneficial to see a window of recent drug use (days to weeks) rather than minutes to hours. It would be very easy for even the most ardent drug user to abstain for the few hours required to show a negative result on oral fluid testing. Consequently, urine drug testing is recommended for most industries where it is required.


Screening for drugs and alcohol in the transportation industry indicates whether a potential employee is fit for the role. A driver is operating a dangerous piece of machinery. A dependence on drugs or alcohol can present risks on the road.


Alcohol testing at PEM has very little utility. Most PEMs are booked with at least 12-24 hours’ notice for the candidate. Almost anyone, even with a serious drinking problem will have a blood alcohol level of 0.00% by the time of their test. In my opinion, a candidate’s history of alcohol use and consumption is more informative than this test.


What are the overall benefits of pre-employment medical assessments?


Comprehensive pre-employment medical assessments provide necessary medical information to help make an informed hiring decision. A pre-employment medical assessment can assist to:


  • Measure the suitability of a potential employee to a specific role
  • Screen potential employees for risk factors that may limit their ability to work in the role
  • Protect the potential employee from working in potentially harmful work environments
  • Increase health and safety standards in the business
  • Improve company morale
  • Lower absenteeism and the risk of lost productivity
  • Reduce exposure to workers compensation claims

If you would like further information about our pre-employment medical assessments, or to discuss the particular circumstances in your workplace, please contact Injurynet on 1300 574 040 or support@injurynet.com.au


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The COVID-19 pandemic is presenting us all with multiple changes and challenges to our everyday lives. Social isolation, restrictions on the way we can connect with family, friends and work colleagues, fragile employment markets, threats to our health and a sense of uncertainty about the future can all accumulate into feelings of anxiety, helplessness and even grief. These are very normal reactions to an abnormal and stressful situation. However managing these responses can be challenging and for people already living with a mental health issue they may find this a particularly difficult time.


Possible Impacts on Mental Health:


  • Feeling more anxious or distressed than usual
  • Withdrawing from social and support networks
  • Not sleeping as well, finding it hard to ‘switch off’
  • Increase in alcohol and drug use
  • Changes to employment and study practices

Looking after your own health and wellbeing:


Individual self-care strategies are things we can do for ourselves to help combat the negative, vulnerable feelings that can take over our thinking at times and can also work to give us a sense of control and power over our situation.


A few strategies to start with:


  • Creating a daily routine is important and while this may be different to your usual, pre-COVID routine, having a plan to your day assists with motivation and also gives you the opportunity to make time for the things you enjoy. Incorporating a consistent exercise and bedtime routine in to this daily schedule can be helpful.
  • Check in with your GP – they can be a really helpful person to keep in the loop with how you are travelling particularly if you feel you are struggling.
  • Look after yourself with a healthy diet and keep an eye out for increased alcohol or drug use.
  • Review your news and media intake. It is important to stay informed but filtering through the amount of COVID-19 news can be stressful so restrict your sources and set a time limit to what you are reading.
  • Speak with your supports; family, friends, work colleagues. Maintaining our relationships is really important and for most of us, outside of our families, that day to day contact would usually be with our work colleagues. The way we engage with our teams may have altered but finding creative ways to stay connected is particularly helpful to battle that sense of isolation.

There may be a time where we recognise we need more support. Seeking this support and speaking with a professional counsellor, like a psychologist, is an important step.


Injurynet mental health support services


Speaking with a Psychologist can help in many ways. By providing a safe space to talk, psychologists can help you build strategies to support your mental health and work with you towards your goals.


Injurynet offers support for employees struggling to cope and requiring medical, psychology and mental health services. We offer both face to face or telehealth appointments with our network doctors or network psychologists. Our 24/7 Nurse Triage phone services are also available to support employees who may be struggling and would benefit from help to know what to do next.


If you would like more information about our COVID-19 mental health support services or would like to discuss your businesses particular circumstances, please contact Injurynet on 1300 574 040 or support@injurynet.com.au



References:

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The coronavirus has had a staggering impact on Australian businesses. The National Cabinet has developed industry-specific workplace health and safety guidelines around COVID-19.


One critical aspect of these guidelines is that businesses must, in consultation with workers, and their representatives, assess the way they work to identify, understand and quantify risks and to implement and review control measures to address those risks.


These requirements are best dealt with via the use of a principle-based approach risk assessment and management program such as the Hazard Analysis Critical Control Point (HACCP) methodology. This methodology, and others you may choose to use, should seek to plan out unsafe practices based on science and focus on the health and safety issues rather than traditional quality control methods.


The following are the key principles that plans should include:


Principle 1 - Conduct a Hazard Analysis.

Principle 2 - Identify the Critical Control Points.

Principle 3 - Establish Critical Limits.

Principle 4 - Monitor CCP.

Principle 5 - Establish Corrective Action.

Principle 6 - Verification.

Principle 7 – Recordkeeping.


The current Safe Work Australia checklists focus on such issues as physical distancing, handwashing and hygiene, cleaning and monitoring symptoms. All measures aim to protect the safety of employees and help employers to proactively plan for these challenges and best position their business for the “new normal”.


Each business’s risk assessment and management plan will look different depending on such factors as:


  • The degree of contact with the public.
  • The vulnerability of the public involved. e.g. are there many older people.
  • The number of workers in the facility and the size of the facility
  • The capacity for remote activity.
  • Coverage for critical staff members if they become ill.
  • Frequency of surface contact throughout the facility including necessary cleaning regimes and types of cleaning products required.
  • Need for PPE. Masks are not recommended in non-health settings.
  • Ability to cohort key staff into separate groups.
  • Capacity to monitor and test staff who are ill.
  • State compliance and jurisdiction.

Injurynet ‘s COVID-19 plan for recovery services are available to support businesses and organisations in the implementation and continual monitoring of their risk assessment and management plan so that employers can continue to operate. Our services support and reassure employers and employees as they manage COVID-19 health risks, exposures and cases so that both employees and communities stay safe and healthy.


We can assist in providing answers to the following common questions including:


  1. When should we let employees back into the workplace?
  2. Are there any steps we can take to reduce our risks associated with employees returning to the workplace?
  3. Is it safe for employees to travel on public transport?
  4. Should we test employee temperatures when they attend work?
  5. What should we do when we identify an employee with a raised temperature?
  6. Should staff wear masks?
  7. Is there anything we can do about our workspace and workflow design to reduce the risk?
  8. What should we do if an employee is suspected of or has a confirmed case of COVID-19 or has been in contact with someone who has?
  9. Should an unwell employee come to work?
  10. After illness, when are employees safe to return to the workplace?

For more information about this topic, download our COVID-19 Plan for the Recovery of Your Business brochure.


The next step is to plan for how the business can adjust and bounce back in a safe manner, as quickly as possible. Australian businesses have been given a new set of rules on how to manage workplaces during the coronavirus pandemic. These national workplace principles were recently released by the Prime Minister after consultation with key groups. The broad outline of what is required under these national workplace principles is available on the following link: https://www.safeworkaustralia.gov.au/covid-19-information-workplaces/other-resources/national-covid-19-safe-workplace-principles.


If you would like further information about our COVID-19 Recovery Services or to discuss the particular circumstances in your workplace, contact Injurynet on 1300 574 040 or support@injurynet.com.au.



References:

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Our Medical Advisors, Dr David Milecki and Professor Paul Van Buynder, have explained the current COVID-19 tests and how to interpret their results.



COVID-19 Tests


There are two types of tests “available” for detecting SARS-CoV-19, the virus responsible for COVID-19 disease.


Nucleic acid tests


These tests look for the actual virus in the body usually from respiratory tract specimens such as a nose swab.

The tests usually identify either two or three components of the genetic material (RNA) within the virus. This RNA is usually identifiable in respiratory samples in the acute phase of infection. Positive results imply the virus is present and with the clinical picture can aid management of ill patients.

The nucleic acid tests developed for SARS-CoV-19 look at parts of the coronavirus that are unique to SARS-CoV-19 so infection with other coronaviruses such as the common cold will not interfere with them.

Negative results do not fully exclude the presence of SARS-CoV-19 and should be repeated if clinical observations, patient history and epidemiological information suggests COVID-19. It may be too early in the infection for the test to be positive.

These tests require complex expensive equipment and access to testing standards and samples. They are only available in major laboratories but are the basis of the COVID-19 response at the moment.


Antibody tests


After a COVID-19 infection the body will make antibodies to the virus and a number of groups are looking at ways to detect these antibodies in the blood. They are not useful in the early stages of illness as they take time to develop after you are already sick.

These tests will become important to determine whether you have had the disease before, whether you are potentially immune to the disease and how long you are immune after an infection. They are also critical in seeing whether possible vaccines produce a protective result.

They have some advantages in that they will detect antibodies even if a patient has recovered where the nucleic acid tests are only positive while you are sick.

There are a number of antibody classes that are produced. Some antibody types such as IgM appear earlier than others while others such as IgG are more long lasting. Antibodies typically take about a week to develop after exposure to SARS-CoV-19, so if a test is positive it is likely that symptoms have already developed and the person who is developing the illness has had several days to spread the virus. COVID-19 is thought to be infectious in the 24 hours BEFORE symptom onset.

See the graph below as a typical depiction of antibody response over time. IgG is a test for immunity and infection that typically takes at least a couple of months to be detectable and is long-lasting (months to years).


A number of highly sophisticated laboratories have worked on developing these tests since the start of the outbreak with Singapore and China reporting test development early on. In addition Stanford University and some other American sites now have tests that are under investigation.

The tests are being compared to blood samples from people known to have the disease to see at what times they are positive and what the results may mean.

Not all antibodies are protective. Those that are protective are called neutrolising antibodies. If the tests demonstrate these antibodies then the person is protected but we still don’t know for how long. We hope it is for years!

If the antibody test finds other non-neutrolising antibodies then the person may not be protected despite a positive result. A lot more work is required in the coming months in this area.

Recently several 15-minute rapid result self-tests were approved by the TGA. These tests are assays of blood levels of antibodies to SARS-CoV-2 performed by finger pricking a sample. They are being marketed as a test of rapid detection of infection. They are being offered to large companies and corporations, which, in itself is a clue, since if they were the magic answer, the medical profession would not need the involvement of companies.

These tests require more evaluation and I can see a situation where people will be incorrectly reassured by a negative result (a false negative – when they have caught the virus), they relax their guard and then spread the virus to friends, family and workmates, all before the test shows up as positive. Clients are advised not to be part of the chain that leads to such potential outcomes.

Antibody tests certainly do have their place as a valid test for medical practitioners. The tests give rapid results, however, they are not a good way to test for acute infection or for the potential to infect others. It is our opinion that the further development of testing and the use of tests is best left to the medical profession until their role is fully evaluated.

Clients should not play a part in making things worse and taking on some legal risk by promoting methods that lead to negative outcomes including the death of staff or their families.

If you would like further information about our COVID-19 Advisory Service, contact Injurynet on 1300 574 040 or support@injurynet.com.au.



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COVID-19 is a global health threat impacting 198 countries (at the time of writing) and triggering the World Health Organisation to declare a global pandemic. It is rapidly changing the nature of business and the way Injurynet currently offers medical solutions for our business partners. We aim to support the extraordinary measures our government, businesses and community are taking to limit the spread of COVID-19 and offer online or virtual medical and allied health services to support businesses during this time.


Our online and telehealth solutions offer an alternative to our face to face medical, physiotherapy and psychology services. All services are available now and endeavour to help your organisation to continue to manage your health and safety requirements during the COVID-19 pandemic.


Key advantages of our online solutions:


  • Access to our network of doctors, physiotherapists and psychologists from anywhere (at work or home)
  • Eliminates the need to travel to or attend a medical clinic
  • Safe and easy access medical assessments and injury management services

Our online medical assessment solutions:


  • AccuRATE, our online pre-employment medical assessment, provides a comprehensive medical history. It is reviewed by our clinical review team and risk ratings are applied. This is a cost-effective service with fast turnaround times.
  • Telehealth medical assessments with one of our doctors or our telehealth functional assessments with one of our physiotherapists. These assessments can use your paperwork and any items that require testing that is not able to be performed online (such as spirometry, audiometry and drug and alcohol testing) can be organised at a later date.
  • A combination of our online pre-employment medical assessment, AccuRATE, and a telehealth medical or functional assessment can also be used.

Our online early intervention and injury management solutions:


  • Our 24/7 nurse triage phone service to support your employees who are injured or ill at work.
  • Telehealth appointments with one of our doctors, physiotherapists or psychologists. Our clinicians can see, diagnose and treat injured or ill workers without the need for an in-person consultation.

If you would like more information about our online or virtual medical solutions or to discuss the particular circumstances in your workplace, contact Injurynet on 1300 574 040 or support@injurynet.com.au   We will be able to discuss and make recommendations that suit your needs.


References:
  1. WHO: Advice for the public https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
  2. Coronavirus disease (COVID-19) Pandemic https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  3. Coronavirus disease 2019 (COVID-19) Situation Report https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200324-sitrep-64-covid-19.pdf?sfvrsn=703b2c40_2
  4. The Department of Health - Telehealth https://www1.health.gov.au/internet/main/publishing.nsf/Content/e-health-telehealth
  5. Telehealth increases safety and efficiency https://www.msn.com/en-au/news/other/e2-80-98telehealth-increases-safety-and-efficiency-e2-80-99-during-gp-consultations/ar-BB11z8PS
  6. The Conversation:The doctor will skype you https://theconversation.com/the-doctor-will-skype-you-now-telehealth-may-limit-coronavirus-spread-but-theres-more-we-can-do-to-protect-health-workers-133062
  7. RACGP: Telehealth to be expanded to all patients https://www1.racgp.org.au/newsgp/professional/telehealth-expanded-for-all-patients

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In Australia, there are multiple jurisdictions with different legislation, guidelines, requirements and reporting to be considered in health monitoring for respirable crystalline silica. No matter where you are in Australia, Injurynet offers an end to end health monitoring medical service to assist your organisation to manage both the potential health effects for your workers and compliance requirements for every jurisdiction.


Injurynet Health Monitoring Service includes the testing of:



We are available to assist in all or any of the following:


  • Design of the program using a risk-based approach with your occupational health and safety representatives
  • Education of all stakeholders. This may include providing information or giving toolbox talks to workers to explain the process and allay any concerns
  • Coordination of testing at either clinics convenient to the workplace or at the workplace itself (not available for radiology)
  • Review of all information by an experienced occupational doctor
  • Following up any abnormal results, arranging additional tests and providing advice and counselling to each worker about their results
  • Provision of a summary report on each worker to the employer and employee
  • Reporting about the program and its outcomes

For more information about this topic, download our Fact Sheet: Injurynet Health Monitoring of Respirable Crystalline Silica (RCS) Fact Sheet


If your organisation would like Injurynet to manage both the potential health effects of respirable crystalline silica your workers and compliance requirements for every jurisdiction. Contact us on 1300 574 040 or support@injurynet.com.au   We will be able to discuss and make recommendations that suit your needs.


References:
  1. SafeWork Australia Health Monitoring Guide https://www.safeworkaustralia.gov.au/media-centre/news/health-monitoring-guide-crystalline-silica
  2. SafeWork Australia About Crystalline Silica https://www.safeworkaustralia.gov.au/book/about-crystalline-silica
  3. SafeWork NSW crystalline silica technical fact sheet https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov
  4. WorkSafe Crystalline Silica: Safety basics https://www.worksafe.vic.gov.au/crystalline-silica-safety-basics
  5. Lung Foundation Factsheet https://lungfoundation.com.au/wp-content/uploads/2018/09/Factsheet-Silica-May2017.pdf
  6. Worksafe Qld Silica lung fact sheet https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  7. Cancer Council Silica Dust https://www.cancer.org.au/content/Preventing%20cancer/workplace/2017/SilicaDust_03112017_V6.pdf

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The World Health Organisation (WHO) is working with global experts, governments and partners to provide advice to countries and individuals to protect health and prevent the spread of the novel Coronavirus (2019 – nCoV).


According to the WHO, the novel Coronaviruses (nCoV) is a new strain of a family of viruses that cause illness ranging from the common cold to more severe diseases, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The Coronavirus is believed to be zoonotic, which means it has been transmitted between animals and people.


The novel Coronavirus (nCoV) is spread through a respiratory route in the same way as cold and flu: sneezes and coughs propelling fine airborne droplets and aerosols into the air or onto hands that then touch other surfaces, or by touching our eyes, nose or mouth after contact with contaminated surfaces.


Signs of the novel Coronavirus (nCoV) can include respiratory symptoms. Some of the respiratory symptoms include fever, cough, sore throat, shortness of breath and breathing difficulties. In more severe cases the infection has been known to cause pneumonia, kidney failure, severe acute respiratory syndrome.


To reduce exposure to and transmission of the novel Coronavirus (nCoV), implementation of infection prevention and control is important.


  • Frequently clean hands by using alcohol-based hand rub or soap and water.
  • When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw the tissue away immediately and wash hands.
  • Avoid close contact with anyone who has a fever and cough.
  • As more information becomes available consider the use of appropriate respiratory protection to reduce exposure to particles. P2/N95 rated face masks are recommended as they filter out droplets and aerosols if worn correctly.

For more information about this topic, download our Fact Sheet: Injurynet COVID-19 Fact Sheet


Injurynet’s Medical Advisory Service including is a specialised support service for employers to help fulfil their responsibilities in relation to employee health. It provides medical expertise and advice regarding health issues impacting work, and work issues impacting health at both an individual and organisational level.


If your organisation would like to discuss the particular circumstances in your workplace, contact Injurynet on 1300 574 040 or support@injurynet.com.au  One of our specialised in-house medical advisors will be able to discuss and make recommendations that suit your needs.


References:
  1. WHO Standard Recommendations and Advice: https://www.who.int/ith/2020-24-01-outbreak-of-Pneumonia-caused-by-new-coronavirus/en/
  2. WHO Coronavirus health topic: https://www.health.nsw.gov.au/environment/air/Pages/bushfire-illness.aspx#smoke
  3. Australian Government Department of Health https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov
  4. The Conversation: https://www.safeworkaustralia.gov.au/topic/weather
  5. The Conversation: https://theconversation.com/coronavirus-outbreak-whos-decision-to-not-declare-a-global-public-health-emergency-explained-130441
  6. Novel Coronavirus (2019-nCoV) advice for the public https://www.who.int/emergencies/diseases/novel-coronavirus-2019

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Smoke from any types of fire (fire, brush, crop, structure, waste or wood burning) can contain a mixture of various sized particles, water, vapour and gases such as carbon monoxide, nitrogen oxides and volatile organic compounds.




Inhaling smoke for a short time can cause (acute) effects. These may include:
  • Itchy/burning eyes
  • Runny nose
  • Shortness of breath
  • Headaches
  • Irritated sinuses
  • Throat irritation
  • Cough

Inhaling smoke for an extended time for those with respiratory and cardiac diseases such as asthma, emphysema, angina and ischaemic heart disease can exacerbate their underlying conditions. The gases and fine particles produced can make existing respiratory diseases worse. Those workers may experience difficulty in breathing, wheezing, coughing and chest tightness.


As workplace injuries and illnesses can occur at any time, the best way for companies to prepare for conditions with high outdoor pollution exposure is to have a risk management plan. This plan will aim to provide a safe work environment which includes:

  • Selection of the right workers for the job during times of high pollution exposure.
  • Being aware of weather warnings and forecasts.
  • Understanding the air quality indexes for the Australian state the worker resides in.
  • Providing personal protective equipment such as eye protection and correctly fitted P2 rated face masks.
  • Providing water and sun protection.

For more information about this topic, download our Fact Sheet: Injurynet Air Pollution Fact Sheet


If your organisation would like further assistance in managing employees who have been exposed to smoke and air pollution, our nurse triage phone service is also available 24 hours a day, 7 days a week. We also provide a national practitioner treatment network for those who need to see a doctor or allied health professional. Our network is the largest network of its kind in Australia, with over 6,500 medical practitioners, physiotherapists and psychologists across more than 2,900 locations.


References:
  1. Environment Protection Authority Victoria – Smoke and your health https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/smoke/smoke-your-health
  2. NSW Government Health – Illness and injury from bushfire https://www.health.nsw.gov.au/environment/air/Pages/bushfire-illness.aspx#smoke
  3. NSW Government Health – Protect yourself from bushfire smoke https://www.health.nsw.gov.au/environment/air/documents/protect-yourself-from-bushfire-smoke.pdf
  4. CDC Wildfire smoke https://www.cdc.gov/disasters/wildfires/smoke.html
  5. SafeWork Australia : Working Outside https://www.safeworkaustralia.gov.au/topic/weather

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What is Asbestos?

Asbestos is a mineral which naturally occurs in rock, soil and sediment. The fibres generally are heat resistant, very light, not visible to the human eye and have insulating properties.


What goods and materials was Asbestos found in and when?

Asbestos products have been used in the industrial and commercial settings since the 1800s. It was commonly used in housing built before the 1980s. Asbestos was used due to its fibres strength, heat resistance and insulating properties. It was largely used for insulation, soundproofing and fireproofing and was found in over 3,000 products.

In Australia, Asbestos was totally banned on manufacture, use, re-use, import, transport, storage, and importation on the 31st of December 2003. Asbestos containing products have been replaced with asbestos-free products for use in roofing, interior and exterior wall cladding, eaves, fencing, water or flue pipes etc.


When was Asbestos mined in Australia and why was it used?

Asbestos was mined in Western Australia, NSW and Tasmania until 1983. Ninety percent of the Asbestos mined was broken down into fibre bundles and mixed with materials (such as cement) to produce a variety of building products.


Why is Asbestos considered a health risk?

Asbestos becomes a health risk when the fibres become airborne and are breathed in. The risk increases with the number of fibres inhaled. Even though Asbestos mining and importation has been banned in Australia. Friable Asbestos and Non-friable Asbestos materials are still found in fibro, pipes, flue, drains, roofs, gutters, brakes, gaskets and clutches products manufactured prior to this ban. Asbestos can become a health risk if asbestos materials are unknowingly disturbed and the fibres are released into the air. The disease develops over decades and exposure can cause Asbestosis, Lung cancer, Pleural disorders and Malignant Mesothelioma.


What key industries has Asbestos been known to affect?
  • Construction and Demolition
  • Telecommunications
  • Utilities such as Water and Electricity
  • Plumbing
  • Mechanical Services

There are three typical cases that would present to Injurynet services
  1. Company Awareness of potential Exposure. In situations where the company has been alerted through their health and safety analysis that a worker may have been exposed to Asbestos. In this case Health Monitoring may be required.
  2. Incident Exposure. In this case an unexpected exposure incident occurs. A Baseline Test (the first episode of Health Monitoring) may be recommended.
  3. Worker Diagnosis. In this case the worker has been diagnosed with a condition such as Asbestosis; our case management process may be helpful.

What is Injurynet’s Health Monitoring Service?

Injurynet services offer an end to end health monitoring service for medical management of Asbestos cases for our clients. This end to end medical management service includes a tailored approach to each case. In the majority of cases our process includes the following:

  1. Design of the Program
  2. Education for the company involved and its workers.
  3. Implementation of the Program

    This implementation process will include collaboration with our network of medical clinics, Radiologists accredited for reviewing occupational lung disease, Spirometrists and Respiratory Scientists. The baseline screening process may include an examination, X-ray (to ILO standard) and Spirometry.

  4. Ongoing Monitoring

    An Injurynet service provides in house occupational doctor services. At this stage of the process, we offer a comparison with the baseline screen.


For all enquiries about our Asbestos Health Monitoring Service. click here


Where can I get help?

References:
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Silicosis is potentially a serious form of occupational lung disease with no cure that has traditionally affected coal mine and quarry workers, but more recently those who work in the engineered stone bench top industry.

Respirable Crystalline Silica RCS is a basic component of soil, sand, granite, and many other minerals. Quartz is the most common form of crystalline silica and it is commonly found in concrete and concrete products such as autoclaved aerated concrete (AAC), stone and composite-stone bench tops, fibre-cement sheeting, bricks, blocks, tiles and pavers, bagged materials such as cement, tile adhesive and mortar.

The RCS-generating processes in the construction industry include the use of the power tools (scabblers, grinders, concrete floor polishers, saws, drills) on silica-containing materials, and mixing of concrete, adhesive or mortar using dry-bagged products. There is also a risk when sweeping or using compressed air or blowers on dusts containing silica.

Assessment and measurement of risk along are the most important measures along with modifying work practices and the use of appropriate personal protective equipment.

Where risk is present, health surveillance or health monitoring is required for the potentially exposed staff in order to identify any health indicators early in the process to limit the severity of any health problems.

Unfortunately, until recently, testing performed in the community has not been of a high enough quality to provide effective surveillance. This has been the case with both x-rays and lung function testing.

Injurynet is familiar with the health surveillance requirements in all states and can facilitate the coordination of high quality health surveillance assessments nationally for your organisation. This will ensure that your workplace meets its obligations with OH+S laws and guidelines and, more importantly, protects the health of your workforce.

To enquire about our services click here

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A significant proportion of Australia’s workforce is based in regional or rural areas throughout the country. These areas often suffer from a low volume of medical clinics and doctors capable and willing to perform the relevant pre-employment medical assessments required to determine their fitness for employment.

Consequently, candidates applying for job roles in these areas often have to travel long distances to attend their pre-employment assessment, and their appointments can be difficult to arrange within specific requested timeframes. Understandably, this can deter potentially suitable applicants from proceeding with a company’s recruitment process, leading to potential loss of valuable additions to their workforce.

A quality online pre-employment medical assessment enables candidates living in regional or rural areas, where there is often a small number of medical clinics available, to complete their assessments in a simple and timely manner, without needing to travel long distances to attend face-to-face appointments.

Apart from the obvious cost savings, organisations receive more detailed and comprehensive data regarding their candidates’ commonly reported health issues, covering more variables than was previously possible. This augmented reporting capacity is useful in tailoring workplace healthcare programs for their employees and narrow down the number of candidates requiring face-to-face assessments.

To enquire about our services click here

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The Journal of Occupational and Environmental Medicine recently published an article titled ‘Concerns About Claiming, Post-Claim Support, and Return to Work Planning: The Workplace's Impact on Return to Work’.

The article highlighted that receiving support and developing RTW plans were significantly associated with greater likelihood of RTW. When controlled for one another in a single model, post-claim support had the strongest association with RTW planning also significantly and positively associated with RTW.

The conclusion drawn was that the provision of both emotional and instrumental support are important employer-led work disability management interventions, and research is required to develop strategies for increasing employer support to lead to improved RTW outcomes for injured workers.

Injurynet's InitialCARE service helps you and your injured workers develop solid RTW Plans with prompt (same day/next day) treatment and capacity advice following a workplace injury.

To enquire about our services click here

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About Us

Since 1998, Injurynet has delivered innovative workplace medical solutions for medical assessments, injury management, fitness for duty and medical advisory services.

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Contact Us

Level 1, 173 Burke Road,
Glen Iris, Vic 3146

+61 3 9500 9968
1300 307 418

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