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Oxford Textbook of Medicine$
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Edited by David A. Warrell, Timothy M. Cox, John D. Firth

Online access to the Oxford Textbook of Medicine in low and middle income countries is available through the World Health Organization-led HINARI Access to Research in Health programme

Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates
include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Occupational safety

Chapter:
Occupational safety
Author(s):

Lawrence Waterman

DOI:
10.1093/med/9780199204854.003.090402

November 28, 2012: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

Any approach to occupational health must acknowledge that accidents in the workplace result in many injuries. Construction, agriculture, and primary extraction are the main causes of fatalities and serious injuries, but many more minor injuries result from all kinds of work.

Health and safety law has developed with an emphasis on accident prevention that is based on designing and managing the working environment by (1) defining appropriate processes and work practices that are safe; (2) developing and maintaining a health and safety culture; and (3) influencing behaviour so that everyone is focused on the best and safest way to do their work.

Establishing this approach to safety management begins with an organization committing itself to a policy influenced by legal obligations and current good practice, such as the developing standards for corporate governance of risks and public reporting. Management systems based on the formula ‘Plan–Do–Check–Act’ are central to accident prevention, with detailed decisions driven by risk assessments.

A key ingredient to safety is genuine worker engagement, going beyond the legal obligations for consultation. Organizations can improve their safety culture when they recognize that this is the product of individual and group values, attitudes, competence, and patterns of behaviour that determine the commitment to, and the style and proficiency of, their safety programmes. A positive culture requires appropriate leadership, including genuine commitment of the most senior manager(s) in the organization, and an appropriate emphasis on competence, such that the right people, trained and skilled, are doing the right job in the right way, with their supervisors and managers having ready access to competent health and safety advice when required.

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