Work-Related Interventions during Office Visits to Occupational Health Physicians 1 Kimmo Ra ¨sa ¨ nen, M.D.,* ,2 Veijo Notkola, Ph.D.,* , † and Kaj Husman, M.D., Ph.D., M.Sc.* *Research and Development Centre for Occupational Health Services, Finnish Institute of Occupational Health, P.O. Box 93 (Neulaniementie 4), FIN-70701 Kuopio, Finland; and †Department of Sociology, University of Helsinki, P.O. Box 25 (Franzeninkatu 13), FIN-00014 Helsinki, Finland Background. Systematically applied work-related interventions during visits to occupational health (OH) physicians support the preventive and health promotive goals of OH. The proportion of the visits including a work-related intervention was analyzed according to patient, health problem, and physician determinants in a sample of visits to OH physicians in Finland. Methods. A cross-sectional study was carried out among 55 Occupational Health Services (OHS) units. Office encounters with 4,404 male and 5,373 female em- ployed patients ages 18–64 years, recorded by 114 OHS physicians, were analyzed. Results. Altogether 856 (8.8%) encounters included a work-related intervention. The work-related interven- tions were distributed across all the main disease cat- egories, the majority of which were musculoskeletal diseases. Of the patient determinants, occupational group (the residual group of non-white-collar or non- blue-collar workers) associated positively with a work-related intervention, while age or gender did not. The physician’s female gender and experience as- sociated positively with work-related interventions. Work-related interventions took place more often in integrated and joint model OHS than in municipal health care centers and private medical centers. Conclusions. Work-related interventions are used by OH physicians for diverse health problems. More re- search is needed to better understand the reasons for the observed differences in work-related interven- tions. Also, research is needed to evaluate the effi- ciency of such interventions. © 1997 Academic Press Key Words: prevention; counseling; primary care; occupational health. INTRODUCTION Depending on the user and the context, work-related health problems are classified in many ways. Many countries have their own criteria for recognized occu- pational diseases for legislative purposes. In the mid- 1980s an expert committee of the World Health Orga- nization defined the term ‘‘work-related diseases’’ as follows: ‘‘In work-related diseases . . . occupational diseases stand at one end of the spectrum.... At the other end, diseases may have a weak, inconsistent, unclear rela- tionship to working conditions; in the middle of the spectrum there is a possible causal relationship but the strength and magnitude of it may vary’’ [1]. In many western countries work-related illnesses and perceived symptoms are common reasons for vis- iting a physician compared with visits due to actual proven occupational diseases [1–4]. Thus, from the practical occupational health (OH) point of view the focus should be more on the perceived discrepancy be- tween work and health. To achieve this goal, more knowledge is needed of the softer aspects of work- related illness (versus disease). This kind of approach would help us to better understand the whole spectrum of work-related health problems, from minor perceived symptoms—which may or may not precede more seri- ous work-related diseases—to proven occupational dis- eases (Fig. 1). Very few studies have explored the amount and na- ture of the everyday work-related ill health seen by OH physicians or other primary care physicians [3,5–7]. The present study sheds some light on this topic from the OH physicians’ point of view in Finland. Finnish OH physicians practice—in addition to their preven- tive-oriented responsibilities—largely as general pri- mary care physicians for the employees [8,9]. Thus, this perspective is especially valuable for exploring the largely unknown area between the perceived work- related ill health and legislated occupational diseases [4,10]. The aims of this study are to describe and analyze the number and distribution of office visits to OH phy- sicians during which a work-related intervention (counseling and advice, written recommendations for the workplace, telephone contacts to the workplace or initiative for a worksite visit) was used (Fig. 1 shaded 1 This work was financially supported by a personal grant (95165) for the first author from the Finnish Work Environment Fund. 2 To whom reprint requests should be addressed. E-mail: kimmo. rasanen@occuphealth.fi. PREVENTIVE MEDICINE 26, 333–339 (1997) ARTICLE NO. PM970148 333 0091-7435/97 $25.00 Copyright © 1997 by Academic Press All rights of reproduction in any form reserved.