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102paul  
#1 Posted : 23 October 2017 10:23:07(UTC)
Rank: Forum user
102paul

An employee has telephoned this morning to say he has been diagnosed with COPD. 

What are our next steps? The employee is not off work sick, do we need to contact the employee's GP?

George_Young  
#2 Posted : 23 October 2017 10:48:14(UTC)
Rank: Super forum user
George_Young

First question I would be asking is what caused the COPD, was it a work related task or a life style choice of the employee.

A Kurdziel  
#3 Posted : 23 October 2017 12:47:21(UTC)
Rank: Super forum user
A Kurdziel

Well after messages of sympathy to the person with the diagnosis, we need to ask several questions:

  • How is this currently affecting their work?
  • How is it likely to affect the work in the future?
  • And more from the H&S point of view is it in any way work related, to both the current job and to past employment.

COPD is not a real disease in the sense that it is not the result of an exposure to a particular agent or organism for example. It is a set of symptoms and people given a diagnosis of COPD are often not told what underlying disease they have just they have a set of symptoms.  If you want answers to the questions above I would refer them to an occupational health specialist.

 

johnmurray  
#4 Posted : 23 October 2017 18:38:30(UTC)
Rank: Super forum user
johnmurray

The hint would be in the name:

Chronic Obstructive Pulmonary Disease.

You can quibble about it not being a "real" disease...

However, the person diagnosed with COPD is unlikely to be impressed.

It may be caused by Bronchitis, Emphysema, Asthma or Bronchiectasis etc.

Either way, the person is ill. He/She will have difficulty breathing and because of that He/She will have difficulty excreting the mucous that is produced normally anyway.

As a result, the person will have reduced lung capacity and an increased incidence of respiratory infection.

Unfortunately, as a result of the difficulty breathing and mucous retention, clearing the infection will take longer than usual, and many find the infection returns quite rapidly.

Antibiotic resistant strains of bacteria also make the treatment difficult.

Usual treatment will be bronchodilators to open the airways, of which there are several different drugs available...long or short acting.

Inhaled corticosteroids are frequently prescribed, to ease the inflammation.

In an acute exacerbation oral Corticosteroids may be precribed, such as Prednisalone, acompanied with high doses of antibiotics.

Either way, a person diagnosed with COPD is ill, the illness is incurable, and will cause them trouble for the rest of their life.

A Kurdziel  
#5 Posted : 24 October 2017 08:44:11(UTC)
Rank: Super forum user
A Kurdziel

By a ‘real disease’ I mean it in the medical sense that a disease is something caused by a particular organisms or agent that leads to a particular set of symptoms. COPD is a diagnosis which describes a set of symptoms but does not give any indication of the underlying cause. This could be work related or it could be something else. That is why you need to talk to an occupational health specialist as they are interested in the cause as well as the symptoms.

Invictus  
#6 Posted : 24 October 2017 08:48:28(UTC)
Rank: Super forum user
Invictus

IF you have read the IOSH magazine then there is now a dirrect link to with people who use a lot of bleach so might have to look at the job. It might not be a real disease but it's not great when you can't breath.

safetyamateur  
#7 Posted : 24 October 2017 09:58:25(UTC)
Rank: Super forum user
safetyamateur

Immediate referral to Occ. Health, I'd say.

A Kurdziel  
#8 Posted : 24 October 2017 10:32:51(UTC)
Rank: Super forum user
A Kurdziel

I know what COPD is: my dad died of it. What I am trying to address as what we can do as H&S professionals about it. A simple diagnosis of COPD does not tell us what caused it or if it is work related.  It gives the GP some direction on how to treat the person but the employer doesn’t know if something at work is making it worse. It might be that the employer needs to change work practices, or arrange for the person to move to another job or worst case let them go. A simple COPD diagnosis will not tell you this.   I think that the person suffering with this illness (I never said it was not an illness) deserves an answer to this, rather than just tea and sympathy.

johnmurray  
#9 Posted : 25 October 2017 01:14:59(UTC)
Rank: Super forum user
johnmurray

Originally Posted by: A Kurdziel Go to Quoted Post
I know what COPD is: my dad died of it. What I am trying to address as what we can do as H&S professionals about it. A simple diagnosis of COPD does not tell us what caused it or if it is work related. It gives the GP some direction on how to treat the person but the employer doesn’t know if something at work is making it worse. It might be that the employer needs to change work practices, or arrange for the person to move to another job or worst case let them go. A simple COPD diagnosis will not tell you this. I think that the person suffering with this illness (I never said it was not an illness) deserves an answer to this, rather than just tea and sympathy.
Smoking is the most prominent cause. Dust and fume at work as well! A1A deficiency leads to development at an earlier age. Most cases are rapidly forwarded to secondary care...the treatment is such that GP prescribing rarely covers it (GPs' are subject to restrictions on antibiotic prescribing, and most COPD sufferers have frequent respiratory infections) If you really want, I can give you an adequate first-hand description of the various treatments available for COPD patients....I have Asthma, Emphysema and Bronchiectasis. The NHS has educated me in home IV administration of antibiotics, I also have several thousands of pounds worth of antibiotics on my meds shelf at the moment, I mix my own IV meds. I wish to thank, quite profusely, the staff (all specialists, many international specialists) at NHS Papworth for my continuing life..
LeanneD  
#10 Posted : 27 October 2017 13:02:15(UTC)
Rank: Forum user
LeanneD

Originally Posted by: 102paul Go to Quoted Post

An employee has telephoned this morning to say he has been diagnosed with COPD. 

What are our next steps? The employee is not off work sick, do we need to contact the employee's GP?

Why would you need to contact their GP if they are not off sick?

What role do they currently do and how does this diagnosis affect that?

Do you think that the COPD (or attributing illnesses) was caused by their work?  have they had long term exposure to harmful pollutants?

What did they hope to achieve by telling you this?  Do they want any next steps to happen or are they happy to manage their condition as it is right now?

Psycho  
#11 Posted : 31 October 2017 15:24:39(UTC)
Rank: Forum user
Psycho

Originally Posted by: A Kurdziel Go to Quoted Post
COPD is not a real disease

What is it then?

 I KNOW i am going to have a terribly slow and horrible death, it may be that my heart just gives in as a fight for my last gasp of air, it may be i get a panic attack fight for breath and my main artery explodes due to the pressure build up or i get a stroke, where i am bed ridden for the rest of my life were i cant speak or move.

At the moment i am mobile i can walk for miles sometimes other days a couple of hundred yards before i have to grab a railing gasping for breath.  in a years’ time I may not be able to walk 20 yards, every day i fight for breath, tonight i may gasp and reach out for my inhaler, to try and open my airways.. Put a damp towel over your face and breath through it -- you will see what its like, you can remove the towel, I can’t replace my respiratory system

I am susceptible to infection having to take 4 types of anti-biotics last time and having a lung infection that lasted for 3 months. I have a lung capacity of 46%, which gets worse each year. i am 50 years old.

why me-- working in the ship yards and a life style of smoking am i bitter -- no i know everyone has to die , but my life will end earlier than it would have. I  have lost more mates dying with asbestos related disease than COPD , or do you not think there is such a thing as asbestos related diseases,  in the last year i have lost 5 mates with cancer  there ages range from 48 to 52, heavy industry and lifestyle, you did not  think it was wrong 34 years ago at the age of 16 stripping out asbestos, chipping leaded red paint off the sides of ships and breathing trike and welding fume-with no protection - times where different

But never say COPD is not a disease actually you could be right '' it’s a death sentence''

A Kurdziel  
#12 Posted : 31 October 2017 15:57:28(UTC)
Rank: Super forum user
A Kurdziel

I am not saying and I have never said that COPD is not a serious illness and a terrible diagnosis but it is not a real disease as it does not have one clear unambiguous cause: You are exposed to this and you get that. It is a diagnosis that doctors use so that they know what to treat but it does not tell you what the underlying cause is, whether it is work related or not and what should be done to manage the illness for an individual in a particular workplace.   

johnmurray  
#13 Posted : 31 October 2017 19:55:28(UTC)
Rank: Super forum user
johnmurray

As an umbrella term for a collection of real diseases, it is reasonable. Asthma: We all know that a large collection of workplace substances can sensitise a person towards it. Bronchitis: Inflamation of lung tissue...oh yes, can be caused by fumes/dust... Emphysema: ditto. Of course, smoking is the accepted predominant cause, but a smoker exposed to workplace air contamination is more likely to develop the above. Then we come to Bronchiectasis. Smoking is not associated with development of it. The causes are either genetic (possession of the cystic fibrosis gene) or toxic fumes....back to work again.. Of course, the guy at the start of this just has "COPD" The real problem arrives when deciding what to do with this employee at work. Obviously, he/she cannot work in contaminated air. His/her lungs will have a predisposition to congestion, his respiratory efficiency will be lower than "normal" people, he/she will have problems clearing the lungs, he/she will be predisposed towards respiratory infections. I can chat quite happily about this, at length. I live a few miles from the best heart/lung hospital in Europe, so hopefully I will live a few more years yet. COPD is real enough to me...and all other afflicted persons. Oh, and it is not cureable. The best that can happen is it doesn't get worse.
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