Towards developing a job-specific workers’ health surveillance for hospital physicians in the Netherlands

Introduction
Hospital physicians are responsible for delivering high quality of care and ensuring patients’ safety. Occupational exposures threaten physicians’ health and their work functioning. We aimed to develop a job-specific workers’ health surveillance (WHS) for hospital physicians by detecting physical exposure limits, adverse health effects, or health effects reducing their work functioning, and to start appropriate preventive interventions.

Methods
To define the content of the job specific WHS, three strategies were used to gather information about job demands and work-related health effects of hospital physicians. First, all hospital physicians (n=958) received a self-report questionnaire concerning emotional, physical and psychosocial occupational exposures and about physical and psychological health effects. Systematic observations by means of an hierarchical task analysis were performed to quantify physical job demands in terms of duration, frequency and intensity, which were then compared with occupational guidelines. By systematically reviewing the literature additional information regarding occupational exposures was obtained.

Results
The questionnaire study indicated that the presence of psychological and physical health complaints should be present in the job-specific WHS. Hospital physicians reported high complaints for burnout, stress and depression, and high physical complaints in the upper extremity. The health effects resulting from exposure to psychological demands, like emotionally demanding situations, and patients material should be part of the WHS. From the systematic observations health effects resulting from exposure to several physical demands as well as from, after reviewing the literature, exposure to chemical demands are relevant for inclusion in the WHS.

Discussion
Hospital physicians are exposed to different kinds of job demands and experience diverse psychological and physical health complaints. The job-specific WHS for hospital physicians should therefore not focus on just one work aspect, but should take all the possible complaints and demands into account in order to detect early signs of reduced work capacity.