Lifestyle Profiles - Occupational Health

I came into Occupational Medicine through the front door; I knew what the speciality had to offer and took a measured approach to making it the focus of my career. But why?

My father had worked in one of the heavy industries all his life, from the 1930s to the 1960s - he was an industrial chemist in a steel works. When I qualified, I could have chosen any path in medicine but other demands on my life took me in one or other direction, and throughout my career until 5 years ago, general practice was a mainstay; particular interests lay in various branches, including, inter alia, Occupational Medicine.

The lessons from general practice were that doctoring could easily become a treadmill in palliative care (for many who were hardly ill anyway); it wasn’t too concerned with treating the causes of serious ill health itself. I could see that, once the major infectious diseases of our time had been brought under control, such as tuberculosis and smallpox, at least here in Britain, the major sources of ill health resided in poor lifestyle or poor choices of lifestyle (alcohol, drugs, diet, smoking) and in work-related causes, and knowing something of my father’s history, work-place ill health was on my doorstep – literally.

I was aware also that, for me, being a complete doctor would have to involve becoming an active participant in three key areas of our profession; disease diagnosis, disease causes and disease treatment. This meant, in broad terms, health promotion, health surveillance and health management and therefore getting to grips with a much bigger picture of medicine than most people, and some of our profession, ever see.

My interest in work-related ill health was fuelled by my ignorance of, and curiosity about, what went on inside factories and, for example, why the air always looked and smelled so different in Middlesborough from the air I was to breathe in Grasmere, where my generally-not-so-ill general practice patients resided; this was symptomatic of the stark contrasts of health between industrial Britain and green Britain.

For many reasons, work-related ill health had largely been a hidden or covered-up problem, and during my early career the covers were coming off. The Health and Safety at Work Act was a political demonstration that a major shift in health awareness had taken place and I was going to become part of it. It’s so fascinating; as an OH doctor you can find yourself involved with anything with a medical connection from Absence at work to Zeneca’s latest drug research. You can find yourself examining a radio-ulnar joint in the morning and radioactive workplace in the afternoon or burying your grey cells in the statistical jungle of epidemiology one day and chairing a committee on health promotion the next. In Occupational Medicine, we have a great chance to see all of medicine at work and to make what could be a vital contribution to the development of medical knowledge, to become a leading expert in our field; we at the cutting edge of our profession, shaping research, policy and treatment. You can’t get more complete as a doctor than that.