Workplace health under microscope

RCPI Faculty of Occupational Medicine, Spring Conference, No 6, Kildare Street, Dublin, 4 April 2025

New guidelines for workplace noise, and the impact of endocrine conditions at work, were key topics at the recent Faculty of Occupational Medicine meeting

The RCPI Faculty of Occupational Medicine Spring Conference, held on 4 April in No 6, Kildare Street, Dublin, was opened by Faculty Dean Dr Alex Reid. He welcomed attendees with an overview of the day’s agenda, noting it would explore a range of health issues and “not uncommon situations that we encounter in the workplace”.

Hearing loss

A session on hearing loss began with a presentation by Dr Martin Hogan, Director of Corporate Health Ireland, Cork, who had previously advised the HSE on its 2007 guidelines for industrial audiometry. Dr Hogan provided an overview of the forthcoming updates to these guidelines.

The updates align with a 2021 change in the UK’s guidelines stipulating: “Where, as a result of health surveillance, the employee has identifiable hearing loss, the diagnosis of noise-induced hearing loss must be confirmed by a doctor.”

Dr Horgan stated the guidelines were updated in the interests of patient safety.

“This was done for the safety of the patient. It has also made the situation more doctor-centric,” he said. The updated guidelines contain advice on how doctors can identify rapid hearing loss by reading audiograms.

In Ireland’s manufacturing and mining industries, 40 per cent of employees are experiencing unacceptable levels of noise at work, according to physiologist Ms Melanie Brewster, Founder, Industrial Diagnostics Company, UK. Ms Brewster delivered a presentation arguing that the UK health service’s categorisation system is likely to miss signs of noise-induced hearing loss. She said the health service’s tool is not sensitive enough for employees, including younger cohorts.

“This categorisation system is so pessimistic in the lower frequencies for younger people,” she said.

According to Ms Brewster, the consequences of missed identification of noise-induced hearing loss includes an increased chance of further hearing deterioration and social isolation in later years. She recommended that occupational medicine physicians use audiograms for measuring hearing thresholds in patients, as they are a very useful tool.

Mr Shane Hamilton, Community Resource Officer, CHIME (the national charity for deaf and hard-of-hearing people), who is deaf, shared his lived experience.

“I have seen in the last 20 years hearing technology getting better all the time,” he said, highlighting the evolution of assistive devices in the workplace – from early tools to today’s advanced microphones that can connect to multiple hearing aid receivers simultaneously.

AI

Dr John Sheehan, Consultant Radiologist, Blackrock Clinic, Dublin, provided an overview of how artificial intelligence (AI) technologies are transforming healthcare. He also spoke about the anticipated barriers for the health service in adopting AI.

Also, Prof Ciaran O’Boyle, Professor Emeritus of Psychology, shared how he founded the Positive Health Medicine Centre at the RCSI.

“To me, what is key to wellbeing in the workplace is leadership,” he said. Prof O’Boyle spoke about models of transformational leadership that measure abundance in the workplace, not just deficits.

He quoted a recent study that assessed the data of one million employees across 1,782 publicly listed US companies and made links between company performance and employees’ ‘happiness index’.

Complaints

A rise in complaints to the Medical Council was the topic of two presentations. Council President Dr Suzanne Crowe explained the regulator’s role as advocating for patients and doctors in a changing environment. Of 364 complaints received by the Council in 2024, nine related to occupational medicine physicians on the specialist register. Most complaints related to dissatisfaction over work certificates and medical reports that have been provided.

Dr Deirdre Gleeson, Medical Director, Medwise Occupational Health Service, said that occupational medicine physicians are at risk of complaint due to obligations not only to employees and employers, but also third parties such as insurers and welfare providers.

In the UK, 28 doctors died by suicide between 2005 and 2013 while under complaint, according to data referenced by Dr Gleeson. She also cited a survey of 114 doctors under complaint in Ireland, 93 per cent of whom said the process caused anxiety.

Infertility

An afternoon session was dedicated to the impacts of endocrine conditions at work. “Infertility is a medical diagnosis, but it can be a social diagnosis too,” said Prof Cathy Allen, Consultant Obstetrician/Gynaecologist, Merrion Fertility Clinic, Dublin. She spoke about the alienation that can be felt by patients receiving fertility treatment and noted that social events, such as baby showers, can be especially emotionally difficult.

“Studies show patients going through IVF are emotionally healthy and not depressed, but there will be strains during the treatment, from feeling a lack of control over what’s going on, from low self-esteem and social exclusion. It’s also an economic stress, with a lack of public funding towards treatment and limited reimbursement on health insurance,” said Prof Allen.

She explained that standard fertility medications might have to be taken in the workplace via injection, followed by visits clinics for scans. “The average IVF cycle requires an average of 23 hours absence from work. Medication administration is highly time-sensitive. There is no statutory entitlement for leave for treatment,” she said.  

“If you’re in a flexible job, you can nip out for an ultrasound scan. That’s grand. If you’re a teacher in the midlands who needs to come up to Dublin, you have to take the day off work,” she said.

Prof Allen advised that workplaces can create a supportive environment by facilitating staff leave entitlements and having discretionary pregnancy loss policies.

Osteoporosis

In a presentation titled ‘Osteoporosis – the silent killer’, Prof Moira O’Brien, Affidea Medical Scan Clinic, warned that it is not normal for employees to break a bone from a trip and fall, even on cement or ice. Prof O’Brien originally became interested in osteoporosis when working as Medical Officer for Team Ireland at the Olympic Games and seeing osteoporotic fractures in athletes. For diagnosing osteoporosis, she advised testing bone density via a dual-energy x-ray absorptiometry scan of the spine and hips and conducting a lateral vertebral assessment.

Diabetes

Finally, Dr Maura Moriarty, Consultant Endocrinologist, Cork University Hospital, gave an update on diabetes technology that is available for employees to use at work. She said that people with diabetes may be monitoring glucose via a sensor worn on the skin, and administering insulin through pens or a pump worn on the body.

Dr Moriarty added that workplaces can support employees with diabetes by making reasonable accommodations – such as being mindful of where insulin pumps and tubing are positioned and ensuring these devices are not dislodged by the physical work environment.

Access to a fridge allows employees to store insulin and wi-fi may be required if employees are using a smartphone app to read glucose levels. “Just because people have diabetes and use technology in the workplace does not negatively impact their performance,” said Dr Moriarty. “With use of technology, their performance should be better.”

Find out more about the Faculty of Occupational Medicine at www.rcpi.ie/Faculties-Institutes/Faculty-of-Occupational-Medicine

This article was produced by the RCPI.