Occupational and environmental medicine (OEM) is a multifaceted medical field encompassing two main disciplines: occupational medicine, concerned with preventive health and work-related injury; and environmental medicine, concerned with the effects of the environment on health.1 Work and environment are important determinants of health, and general practitioners (GPs), as whole-person care providers, recognise the importance of considering a patient’s current and past occupation, the work environments these jobs exist in, as well as the broader environments in which we live and their impacts on health.
Over 500,000 people are estimated to experience a work-related injury or disease each year, with men experiencing workplace injuries more frequently when compared to women.2 Work-related injuries can include musculoskeletal injury, dermatological diseases, outbreaks of communicable diseases, ophthalmological injuries and psychological injury, while in rural areas, farming accidents can have significant impacts.3 GPs play an important role in treating these conditions and assisting patients in their return to work. They can also be involved in assessing a patient's fitness for a new job or change of category.1,4,5 GPs need to have a clear understanding of harmful exposures related to a range of occupations and be able to work with patients and organisations, where required, to prevent work-related illness and promote wellness.1,5
Work is an important social determinant of health and participating in ‘good work’ is health protective, contributes to improved self-esteem and a sense of identity. GPs are well placed to guide and educate their patients on the health benefits of good work.6 Furthermore, as workplaces and employment types continue to evolve (eg the rise of working from home and the increase of labour hire firms),1,7 GPs need to stay informed of changes to occupational medicine presentations and their related medico-legal responsibilities. General practice itself is a workplace and practice owners, managers and employees need to ensure it is a safe place for those employed there.
In providing comprehensive healthcare, GPs need to consider the effects of the physical environment. Environmental medicine encompasses environmental hazards generated by industry (eg air pollution or chemical spills),1 the health effects of environmental events (eg natural disasters), as well as specific risks posed to patients living and travelling throughout Australia. More broadly, it describes the fundamental dependence of human health on a healthy environment. Spending time in nature has been associated with a range of physical and mental health benefits, including lower rates of chronic disease.8
Human health is dependent on the world’s natural environmental systems to provide clean air, fresh water, food and a stable climate. The World Health Organisation recognises that ‘Climate change is the greatest threat to global health of the 21st century’.9 Climate change directly affects health through increased frequency and severity of extreme weather events (including extreme heat, bushfires and associated air pollution, floods, storms and droughts). Climate change indirectly affects health through a myriad of systems including infectious disease (diarrhoeal and vector-borne), airborne allergens (triggering asthma, dermatitis and allergic rhinitis) and food and water insecurity. These changes can contribute to population displacement and conflict.10-12 They also cause a significant burden of mental ill health. Importantly, climate change is exacerbating pre-existing health inequities.13 For many Aboriginal and Torres Strait Islander individuals and communities, climate change is threatening to disrupt cultural connections to Country that are fundamental to health and wellbeing.14
GPs are well placed to identify and manage the adverse health effects of climate change and advocate for policy changes at the local, state, national and international level.15 Healthcare is responsible for 7% of Australia’s greenhouse gas emissions. GPs can address and reduce the health and environmental harms associated with healthcare by reducing low-value care and improving practice sustainability.