Marcinkiewicz Andrzej
Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego / Departament of Occupational Diseases and Environmental Health).
Med Pr. 2020 Jul 24;71(4):429-441. doi: 10.13075/mp.5893.00982. Epub 2020 May 6.
The number and activities of occupational medicine physicians and occupational health service (OHS) units can be determined on the basis of obligatory medical reporting.
The paper covers an analysis of the MZ-35 and MZ-35A statistical forms dated 2014-2018. In order to assess the scope of medical reporting, an online questionnaire survey among occupational medicine experts was performed.
the scope of medical reporting, an online questionnaire survey among occupational medicine experts was performed. Results: There were 6685 occupational medicine physicians, 6005 basic OHS units and 20 regional occupational health centers (ROHC) registered in Poland in 2018. Certain regional differences in access to OHS can be noticed. On average, there were 3481 persons of productive age per 1 occupational medicine physician. On average, in 2014-2018, 5 223 000 prophylactic examinations of workers were performed annually, along with 322 000 examinations (also annually) related to the practical vocational training of pupils, students, participants in qualification vocational training and Ph.D. candidates. For the first time in history, in 2018 more preliminary than periodic examinations were performed. Every year, approximately 0.03% of the medical certificates regarding the existence or lack of medical contraindications to perform work, which are issued by basic OHS units, are being questioned by either employees or employers. In 58% of such cases, the initial decision was changed as a result of an appeal procedure in ROHC. The duty to submit an annual report regarding prophylactic praactivities has been obeyed by <60% of the obliged physicians in the recent 2 years. Among the most important reasons for such a situation, the implementation of online reporting, a lack of real consequences for not submitting the report, and a poor knowledge of said reporting among physicians were mentioned.
It is necessary to monitor, on the regional level, the availability of prophylactic care provided by OHS physicians, both for all employers obliged to provide such care and for all employees obliged to undergo medical examinations. The scope of obligatory public statistics reporting regarding OHS activities needs updates. Due to a relatively stable situation in relation to the types of issued certificates, it should be less detailed. Med Pr. 2020;71(4):429-40.
职业医学医师的数量和活动以及职业健康服务（OHS）单位可根据强制性医疗报告来确定。
本文涵盖了对2014 - 2018年MZ - 35和MZ - 35A统计表格的分析。为评估医疗报告的范围，对职业医学专家进行了在线问卷调查。
为评估医疗报告的范围，对职业医学专家进行了在线问卷调查。结果：2018年波兰登记有6685名职业医学医师、6005个基础OHS单位和20个地区职业健康中心（ROHC）。可以注意到在获得OHS服务方面存在一定的地区差异。平均而言，每1名职业医学医师对应3481名生产年龄的人员。2014 - 2018年期间，平均每年进行522.3万次工人预防性检查，以及32.2万次（同样为每年）与学生、学员、资格职业培训参与者和博士研究生的实践职业培训相关的检查。2018年，初步检查的数量首次超过定期检查。每年，基础OHS单位出具的关于是否存在工作医疗禁忌的医疗证明中，约0.03%受到员工或雇主的质疑。在58%的此类情况下，经ROHC上诉程序后初始决定发生了改变。在最近两年中，不到60%的应履行义务的医师遵守了提交预防性活动年度报告的义务。在造成这种情况的最重要原因中，提到了在线报告的实施、未提交报告没有实际后果以及医师对该报告的了解不足。
有必要在地区层面监测OHS医师提供的预防性保健服务的可及性，这既针对所有有义务提供此类保健服务的雇主，也针对所有有义务接受医学检查的员工。关于OHS活动的强制性公共统计报告范围需要更新。鉴于所发放证书类型的情况相对稳定，报告应减少细节。《医学实践》2020；71(4)：429 - 440。
