Koh D, Chia H P
Department of Community, Occupational and Family Medicine, National University of Singapore.
Ann Acad Med Singap. 1994 Sep;23(5):737-41.
The training of primary health care workers in occupational health is important for the provision of occupational health care to the workforce. In Singapore, over 400 Designated Factory Doctors, mostly general practitioners, have been trained. Occupational health is also incorporated in the training of family medicine trainees. Referral centres for cases of suspected work-related diseases are also available. Two specialist occupational health clinics function within Government polyclinics serving the large working population in Singapore. One such clinic operates every Wednesday morning at the Jurong Polyclinic. In the last four years, 485 patients with work-related complaints were seen. There were 268 cases (55%) of occupational skin disease, 74 patients (15%) with respiratory complaints, 38 patients (8%) with acute toxic exposures and 36 patients (7%) with musculoskeletal complaints. Three hundred and forty-nine of the referrals (72%) came from the Jurong Polyclinic doctors, with small numbers from other polyclinics and neighbouring private practitioners. The experience gained in conducting this clinic demonstrated that significant numbers of diseases seen at the polyclinic are work-related in varying degrees. Hence, there is a need for the further development of occupational health care delivery within the primary health care system. This can be achieved by improving occupational health training for all primary health care workers, providing an occupational health resource person at primary health care centres, and raising the awareness of such referral facilities in occupational medicine.
对基层医疗工作者进行职业健康培训，对于为劳动者提供职业健康护理至关重要。在新加坡，已有400多名指定工厂医生（大多为全科医生）接受了培训。职业健康内容也纳入了家庭医学实习生的培训之中。对于疑似与工作相关疾病的病例，也设有转诊中心。在为新加坡大量劳动者服务的政府综合诊疗所内，有两家专科职业健康诊所开展工作。其中一家诊所在裕廊综合诊疗所每周三上午营业。在过去四年里，共接待了485名有工作相关诉求的患者。其中有268例（55%）职业性皮肤病、74名患者（15%）有呼吸道疾病、38名患者（8%）有急性中毒暴露情况以及36名患者（7%）有肌肉骨骼疾病。349例转诊（72%）来自裕廊综合诊疗所的医生，来自其他综合诊疗所和邻近私人执业医生的转诊数量较少。开展该诊所所积累的经验表明，综合诊疗所中所见到的大量疾病在不同程度上都与工作相关。因此，有必要在基层医疗体系内进一步发展职业健康护理服务。这可以通过加强对所有基层医疗工作者的职业健康培训、在基层医疗中心配备一名职业健康顾问以及提高职业医学领域对此类转诊设施的认知度来实现。
