Improving occupational health - Institut universitaire romand de ...

professor dr brigitta danuser-niderÖstProDocHealth@WorkProDoc is a joint initiative between three universities in Switzerland toprovide education and research opportunities for PhD students acrossthe country. Importantly, the scheme is set to produce a new generationwho will help strengthen Switzerland’s research into occupational healthand, better still, contribute on an international platformDespite huge efforts being made inEuropean countries to prevent occupationaldiseases and injuries, the cost of these afflictionsis still worryingly high and continues to rise. Tocombat this alarming trend, drastic action mustbe taken. However, the pitfalls of occupationalhealth (OH) are not simply finance-related. Inorder to effect a shift in expenditure, generalunderstanding and treatment of OH needsto improve. Many believe that it should nowbe considered one of the main public healthproblems – a social, as well as an economicneed. Indeed, the most common OH problemsrange widely, from musculoskeletal injuryto mental health problems. Furthermore,continuing demographic developments, aswell as the intensification and accelerationof the working society and the increasingcompetitiveness of the global economy,accentuate the importance of health, workability and workforce performance.It is paramount, therefore, that employers andgovernments analyse the situation for their ownworkforce. For example, it must be establishedwhether all employees have access to an OHservice and, if so, whether it is functional inresponding to people’s needs. Such basic,preemptive measures are fundamental in earlyrecognition of occupation-caused and relatedhealth problems. Overall, access to and qualityof OH services has to be improved. One wayof ensuring that the necessary improvementsare made is to provide better research andeducation surrounding OH. These very needs arebeing diligently tackled by a group of academicinstitutions, led by Professor Dr BrigittaDanuser-Nideröst.ProDoc health@workFor Danuser-Nideröst, OH research shouldbe interdisciplinary, covering epidemiology,chemistry, physics, engineering, medical,psychological and organisational research.Her team considers their OH research to beneed-driven, taking into account the economicstructure as well as the social and medicalsystems of each particular country.To ensure that this approach to OH research isimplemented at the earliest possible stage, theparticipating institutions have implemented‘ProDoc Health@Work’ for PhD students. Thisinitiative offers a formal programme in whichOH PhD students can acquire basic skills andknowledge, as well as being given the opportunityto network with other PhD students andresearchers working in similar fields. However,most importantly of all, the programmeproduces a number of students who, in future,will help strengthen existing research groups andconsolidate OH research in Switzerland, in aninternationally competitive environment.The course offers modules which target specialresearch and methods skills. Specifically, theycover overviews of occupational, organisationaland public health transdisciplinary skills.Furthermore, students complete exposureassessments, epidemiologic OH research andqualitative research, and must also considerresearch method triangulation, gender studiesand company epidemiology.Beyond health, the programme and its leadershope to stress that OH research should22 International innovation

enlarge its focus to ‘a working life participationperspective’. This means incorporating factorssuch as work ability, quality of working life,motivation and engagement, as well as microandmacroeconomics, management and thesocietal perspective.The importance of collaborationThree universities contribute to the scheme– the University of Zurich, ETH Zürich andthe University of Lausanne. This collaborativeaspect has certainly informed the success of theprogramme. The research centres are localised inthe two dominant language areas of Switzerlandand all three offer the opportunity to obtain aPhD in OH. The Zurich partners and the Institutefor Work and Health (IST) of the University ofLausanne have been collaborating on the MASin Work and Health since 1993. “Partnershipsare important everywhere today, but especiallywhen resources are sparse – as is the case withOH in Switzerland,” Danuser-Nideröst explains.The central ideas of ProDoc were created byvarious researchers from the three institutions.Since then, the programme has continued tobe collaboratively developed. This methodsuccessfully brings together different OHresearch approaches and topics. The PhDstudents therefore profit from experiencingthe advantages and avoiding the pitfalls ofthese different approaches, through knowledgeof a wide range of previous PhD studentprojects. Additionally, the collaborationgives the programme depth, as differentresearchers represent a variety of OH researchmethodologies and networks.Complex research andthe project’s challengesThe successful implementation of a newcollaborative PhD programme is not withoutits challenges. For instance, the spectrumof OH research in Switzerland currentlybeing conducted – including mixed chemicaland physical exposures to newly emergingnanoparticles and research into the interactionsbetween physical, psychosocial and healthsystem factors in work-related disorders – isdifficult to incorporate into a single programme.More complex still is the investigation ofpsychosocial factors and mental health issues.This necessitates precise research questions, aswell as integrated intervention approaches thatmeet the needs of a fast-changing, increasinglycomplex and service-driven economy.Despite the difficulties and wide scope ofresearch interests, Danuser-Nideröst maintainsthat the project should continue along itscurrent path: “ProDoc should contribute tothe most important research domains, suchas physical harm due to work or workingconditions, psychosocial risk and interventionand prevention studies”. The meticulouseffort that the team puts into investigatingdifferent aspects of OH is vital as, without it,the necessary qualifications and training inOH would be rendered merely superficial –Three universities contribute to thescheme – the University of Zurich,ETH Zürich and the University ofLausanne. This collaborative aspecthas certainly informed the successof the programmeespecially concerning postgraduate trainingand ever-evolving professional qualifications.Overall, those behind the project hopeto achieve a holistic understanding of thework and health relationship, an especiallychallenging feat in light of the ultimate aim oftransferring and implementing the results andknowledge internationally.Unfortunately, ETH Zürich has decided todiscontinue its OH research, and will ceaseits support of the collaborative project at theend of 2013. The University of Zurich will takeover the work conducted on the formationof Work and Health specialists, but researchjobs are not guaranteed. Countries such asCanada, or those in Scandinavia, have rightlyacknowledged the high relevance of OH, andhave subsequently created national researchcentres with funding designated specificallyfor OH research. Such a sensible approach isenvied by Danuser-Nideröst, who worries thatSwitzerland may lose its competitive edge:“OH research, more generally, does not seem‘sexy’ enough for our universities”.Looking forwardIn terms of ProDoc, the team has alreadyplanned and realised two summer schools, oneon societal questions and existing indicators,and the second on the topic of mixed methodsin OH, both lasting four days. They have inviteda Canadian expert and the PhD students profitedstrongly from the interactive teaching whichsupplemented their own research endeavours.Complementary to the ProDoc teachingmodule will be research modules for the PhDdissertation projects. It is hoped that thesewill cover four main domains of OH research:exposure to mixed chemical hazards, exposureto psychosocial factors, organisational healthinterventions and return to work research. Thesedomains will consider the main, internationallyacknowledged, research needs and academicpotential, as well as the core competency areasof the applicants.Overall, during the first three years of ProDocHealth@Work’s existence, 15 PhD projectshave already been planned. It is hoped that inthe coming years the programme will be ableto increase this number substantially. Withthis in mind, it would seem that the goodwork of ProDoc so far and its great breadth ofinvestigation will continue to strengthen.IntelligenceProDoc Proposal Health@WorkOBJECTIVESTo provide the next generation ofoccupational health (OH) professionals thebest possible PhD training for their future roleas scientists and experts.KEY COLLABORATORSProfessor Dr Georg F Bauer, PD MD DrPH,Head, Division of Public and OrganizationalHealth (POH), University of Zurich/ETH Zürich,SwitzerlandProfessor Dr Theo Wehner, Prof Dr habil,Director, Centre for Occupational andOrganizational Health Sciences, ETH Zürich,SwitzerlandFUNDINGUniversity of LausanneThe Swiss National FoundationCONTACTProfessor Dr Brigitta Danuser-NideröstDirectorInstitut universitaire romandde Santé au Travail (IST)Route de la Corniche 21066 EpalingesLausanneSwitzerlandT +41 21 314 7421E brigitta.danuser@hospvd.chwww.i-s-t.chPROFESSOR DR BRIGITTA DANUSER-NIDERÖST is Professor of OccupationalMedicine at the University of Lausanne. Since1993, she has been involved in the creation andcontinuous improvement of the MAS Work andHealth, which qualifies occupational physicians,hygienists and new OH management specialists.Her personal research domains are occupationalrespiratory health, psychophysiology ofemotions and cognitive aspects of workdemands, as well as return to work research.The IST is an OH Collaboration Centre of theWorld Health Organization and contributesto national and international OH researchand implementation strategies. It also offerspractical advice to organisations to find solutionsfor OH problems.www.researchmedia.eu 23