OEMAC Frequently Asked Questions

What are the training and credentials required for Canadian qualifications in Occupational Health and where can I find them?

Credentialing in Occupational Medicine in Canada can occur through the Royal College of Physicians and Surgeons (specialty training – FRCP) or the Canadian Board of Occupational Medicine (CBOM). There are also post graduate degrees available in occupational health (Masters and Diplomas). On the OEMAC Homepage, click the CBOM button and go to the Canadian Board of Occupational Medicine homepage for educational requirements and educational opportunities.

What resources are available for physicians working in occupational health settings in health care?

The importance of Occupational Infection Prevention and Control in health care settings has become increasingly recognized post-SARS and has been highlighted in a number of expert panel reports. It will also become part of the mandate of the new Ontario Agency for Health Protection and Promotion. There are many infectious exposure risks in health care. Strong occupational health programs are needed to protect health care workers through immunization, post-exposure treatment/prophylaxis and Sharps programs. Helpful downloads free of charge include the Canadian Immunization Guide 6th Edition 2006; Public Health Agency of Canada’s 6th Edition of Canadian Tuberculosis Standards; Health Canada’s Occupational Infection Prevention and Control in Health Care Settings and the OHA/OMA Communicable Disease Surveillance Protocols. As well the PIDAC Best Practice , outlines required elements in an occupational health program.

How do I find specific Canadian expertise to help me with my specific problem?

Go to the OEMAC Directory and look for specific expertise or interest areas and/or contact the OEMAC office or a member of the Executive who will gladly try to connect you with a good contact person.

Clinical FAQs

What is the difference between a worker with chronic pain and a worker with chronic pain disorder (syndrome)?

Chronic pain is a state of an injured worker who is experiencing pain due to illness or injury lasting longer than 6 months. Some experts use 3 months as the cut off. An injured worker with chronic pain often has some restriction needed to allow for functioning at work to continue. There is little change in the lifestyle of the worker and the worker copes as best he/she can.

Chronic pain disorder is a DSM IV diagnosis and is an illness behaviour that an individual manifests after the 3 to 6 month period. The illness behaviour is characterized by catastrophic thinking and beliefs. The injured worker fears movement due to pain as well as fears reinjury. The worker often curtails their life remarkably. They may stop work. They may have difficulty sleeping and use excessive narcotic analgesics with little reported relief to their pain. They cope passively with their pain and view the medical community as having failed them and having missed the elusive diagnosis. They are often depressed for long periods of time. They are extremely difficult to treat by unimodal medical treatment. Research shows the benefit of multidisciplinary treatment with emphasis on a cognitive behavioural approach.

What is the maximum narcotic dosage used for chronic pain disorder and what is the best drug to chose?

Narcotics are often used to treat chronic pain in an individual who is suffering from chronic pain disorder. The literature tells us that there is no ceiling for the treatment of chronic pain. This statement is based in the research surrounding the treatment of chronic pain in cancer patients and then fully translated for non cancer patients. If one has the above described syndrome the use of narcotic analgesics often complicates the picture and results in little improvement in function but results in a worker with considerable side effects. The narcotics can ramp up the central sensitization of the pain and in fact increase the pain sensation. Many injured workers will be constipated, have disturbed sleep architecture and be suffering intermittent withdrawal symptoms.Low dose long acting narcotics to no greater than 120 mg of morphine equivalents daily should be used as little benefit seems to be produced from a higher dose.

Prior to the use of narcotics it is advisable to begin with NSAID’s, Neurontin or Lyrica with an attempt at using Topomax as well .

What are the OHA/OMA Communicable Disease Surveillance Protocols?

These protocols were developed to meet Regulation 965 under the Ontario Public Hospitals Act (1990). They are developed and approved by the Ontario Hospital Association/Ontario Medical Association and the Ministry of Health and Long Term Care. They outline preplacement requirements, exposure, and post-exposure treatment/prophylaxis and worker restrictions in acute care settings. There are protocols for Rubella, Measles, Mumps, Varicella, Enteric diseases, Cytomegalovirus, Bloodborne Pathogens, Adenovirus, Pertussis and Tuberculosis.

Any further questions can be directed to the OEMAC office at (888) 223-3808 or by email to info@oemac.org

OEMAC - Occupational and Environmental Medical Association of Canada