Unravelling the ‘Dutch paradox’ of OH profession

Delegates were introduced to the ‘Dutch paradox’ of OH by Dr Carl Hulshof,
co-ordinator of the Coronel Institute for Occupational and Environmental
Health, University of Amsterdam.

The ‘paradox’ is where the Dutch Government passed legislation requiring all
employers to contract an OH service, meaning the coverage of OH services has
risen from 40 to 95 per cent of the population.

Yet because of an emphasis on sickness absence management and the commercial
approach taken by many OH services due to the legislative impetus, many of
these OH services do not have a good reputation, and the quality of their care
does not meet professional standards.

In response, the Dutch Association for Occupational Medicine (NVAB) launched
a programme in 1998 to publish a series of evidence-based practice guidelines
for the most prevalent health problems that lead to sickness absence and ill
health cased by work.

The guidelines have address-ed the management of staff with lower-back pain,
work-related mental disorders, hand, neck and shoulder complaints, and asthma
and other respiratory disorders.

They have also looked at the assessment of the workability of staff in
sheltered workshops and the assessment of visual acuity of VDU workers.

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