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  1. Fitness for work: The medical aspects (5th edition)
  2. Fitness for Work: The Medical Aspects | American Journal of Occupational Therapy
  3. Fitness for Work: The Medical Aspects
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Coming at a time of global change and undertaking, the book explores new developments related to the issue of people being able to perform their jobswhile accepting certain health limitations. The expanded notion of so-called disability in the setting of work is refreshing This book is as useful to primary care practitioners as it is to those engaged in occupational medicine and ancillary fields.

It is also a good reference for risk assessorsand decision makers I found myself sharing parts of this comprehensive, insightful, and interesting book with others. The successive forewards and prefaces to all four editions make inspiring and provocative reading, well worth introductory browsing time to realise the full design and value of the work.

Four editions in 20 years is a remarkable achievement for any medical textbook and reflects not only the changes and advances in medicine, legislation and the practice of occupational medicine that have occurred, but also the esteem in which the book is now held. It is keenly priced and should be on everyoneas bookshelf. You may have already requested this item. Please select Ok if you would like to proceed with this request anyway. WorldCat is the world's largest library catalog, helping you find library materials online.

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Fitness for work: The medical aspects (5th edition)

Your list has reached the maximum number of items. Please create a new list with a new name; move some items to a new or existing list; or delete some items. Your request to send this item has been completed. APA 6th ed. Note: Citations are based on reference standards. However, formatting rules can vary widely between applications and fields of interest or study. The specific requirements or preferences of your reviewing publisher, classroom teacher, institution or organization should be applied. The E-mail Address es field is required. Please enter recipient e-mail address es.

The E-mail Address es you entered is are not in a valid format. Please re-enter recipient e-mail address es. You may send this item to up to five recipients. In fact it has a long history originating from the times when young men were required to undertake tests of endurance for their tribal initiation as warriors.

More recently it has taken the form of pre-employment health assessment, health surveillance, and screening during work. However, assessment of fitness to or for work according to Battigelli1 has two aspects: "On one side it presents the functional and anatomical endowment of the subject examined and on the other, the task to which the individual is operationally fitted".

The recent implementation of the Disability Discrimination Act appears to have accelerated the debate on assessment of fitness to work following a period of illness and the diagnosis of a health deficit.

Fitness for Work: The Medical Aspects | American Journal of Occupational Therapy

The tribunal established that the employer has to ensure that an effective assessment of fitness to work is undertaken, before deciding on the employment status of the now "disabled" employee. It is clear that occupational health nurses need to recognise the legal requirements of employment for the benefit of both employers and employees. What would be desirable is a framework that would help integrate the many variables that need to be considered when assessing fitness to work of an employee diagnosed with a health deficit, or for assessing disabled people for employment.

This article proposes such a framework, taking into account the intricate relationship between employers and employees. It is not the intention to evaluate the current battery of assessment tools in use, but rather to consider the factors that should be considered when assessing the fitness of employees returning to work following the diagnosis of a health deficit. The framework could also be used to help with documenting the assessment process. The proposed framework fits in with the two aspects suggested by Battigelli1 and includes the work environment and legal aspects to ensure that the assessment is comprehensive, equitable and transparent.

Assessment of fitness to work must take into consideration personal aspects, work characteristics, work environment and legal aspects. From a clinical perspective, the whole process of determining fitness is a series of measurements and, as such, is an exercise in relativity. The extent of fitness or impairment must be gauged in terms of the demand of the task to be performed.

However, this will obviously not be a consideration when assessing the fitness to work of an office worker. Assessment must be made for each individual as generalisation of assessment for fitness to work, based on medical criteria alone, may not stand up in court. An individual with Multiple Sclerosis may be able to continue with the same job for many years after diagnosis before any disability or impairment affects work performance.

Equally, another person with the same diagnosis may require deployment much earlier because of the rate or progress of the disease. When assessing each person, past occupational experience, skill levels, technique and ability have to be taken into account in light of the medicalhistory. Clinical assessment may explore basic stamina and physiological endowment3 and examples of methods used are maximal work capacity, oxygen consumption and aerobic capacity, plus a range of motion and related features or strength testing. Besides these, it may be necessary to undertake a battery of tests and to explore lifestyle that may inadvertently impact on work performance.

Disability applies equally to physical and mental impairment4. An illness or injury resulting in disability may well leave psychological scars. Thus, assessment of fitness to work has to consider the psychological, physical, sociological and intellectual aspects of health. Care must be taken that assessment for fitness to work does not become a mere inventory of anatomical and functional attributes without attempts to compare the individual to his or her work. The fitness to work model advocates that the OH nurse needs to have a thorough knowledge of the job specification in terms of essential and desirable qualities required for that job.


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The extent of fitness or impairment must be weighed in terms of the demand of the job to be performed, the specific type, intensity concentration, strength, vigour , duration length of time and schedule shift patterns, etc. Liaison with human resources and management is essential in establishing the fitness standards required for specific jobs or areas of work. For certain occupations such as drivers5,6, offshore workers7 and teachers8, standard requirements for fitness to work are published in key documents and these need to be consulted.

Equally, some professional associations provide guidelines for standard requirements on fitness to work, such as those produced by the Association of National Health Occupational Physicians for healthcare professionals, the Association of Local Authority Medical Advisors for fireman and police, and the Joint Aviation Authority for pilots.

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It therefore aids transparency and equitability. For some jobs, there may be a need to test hand-eye co-ordination and the work-pause sequence may need to be examined in relation to individual abilities or impairments. It may be necessary to take into account the timing of meal breaks, for example, for people who have health conditions such as diabetes.

Fitness for Work: The Medical Aspects

The effects, including known side effects, of medication taken by the employee should also be considered as these may impact on the health and safety of both the individual and others including co-workers, contractors, visitors, customers or clients. Coming at a time of global change and undertaking, the book explores new developments related to the issue of people being able to perform their jobs while accepting certain health limitations. The expanded notion of so-called disability in the setting of work is refreshing This book is as useful to primary care practitioners as it is to those engaged in occupational medicine and ancillary fields.


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  8. It is also a good reference for risk assessors and decision makers I found myself sharing parts of this comprehensive, insightful, and interesting book with others. It is keenly priced and should be on everyones bookshelf. Added to basket.

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