AFOEM eBulletin – 13 November 2020
A message from your President
After a long second wave, some great news out of Victoria is that, as I write this, it’s the 12th day in a row of a ‘double donut’, zero COVID-19 cases and zero deaths. This takes us through almost one cycle of the infectious period, so it looks very promising that community transmission of the virus has been completely suppressed, if not entirely eliminated. Time will tell. The ‘ring of steel’ separating Melbourne from rural and regional Victoria has been removed and there is now free movement across the state. There are positive signs about the lifting of state border restrictions and people from Aotearoa New Zealand are now able to travel to some states of Australia. Finally, we are moving towards some degree of pre-pandemic normality.
Of course, this does not mean that the effects of the COVID-19 pandemic in our two countries have disappeared. The economic fallout, with its severe reduction in employment and associated mental health effects, has a long way to play out yet. With cases surging again in much of the rest of the world, most notably Europe and the USA, international travel is still a long way off. The big hope is for an effective COVID-19 vaccine and there are some promising preliminary results from phase three clinical trials for at least one vaccine. This has prompted the Australian Health Minister to declare that a vaccination program will start in March 2021. Sounds optimistic and the logistic challenges are huge, but there looks to be some light at the end of the tunnel.
The most recent AFOEM webinar was the annual Kevin Sleigh Memorial Lecture, which was arranged by the Victorian Regional Committee. The speaker was Dr Ian Hosegood, Chief Medical Officer for Qantas. Ian gave a terrific talk on the many challenges facing the aviation industry as a result of the COVID-19 pandemic. Interestingly, cases of documented spread of the virus between passengers or between staff and passengers has been rare, despite a lot of people in very small spaces while in-flight. One factor is thought to be the large rate of air turnover with vents low down in the aircraft, generating a downdraft effect keeping any airborne virus away from the breathing zone. Fomite transmission though contaminated surfaces is also thought not to be a major factor on aircraft. Ian also outlined the many changes which have been introduced by the industry to minimise the risk of contracting COVID-19 in-flight. On a personal note this is great news, as I usually spend a considerable amount of my time in the air, but I haven’t been on an aircraft since February. Hopefully, this will change soon.
The second of our Health Benefits of Good Work (HBGW) COVID-19 webinars for the HBGW signatories was held on Monday, 2 November and the annual HBGW Industry Forum was held on 11 November. This year the Forum was held virtually and the topic was: ‘Promoting the Health Benefits of Good Work during COVID-19’. We heard from three excellent speakers on vulnerability (Rachael Palmer), family violence (Cathy Oddie) and job design (Sara Pazell). Dr Warren Harrex also spoke of the history and aims of the HBGW, which is about to celebrate its 10 year anniversary. The Forum was very ably chaired by Noni Byron, Chair of the HBGW Forum Committee. The Forum ended with a panel discussion and a flurry of questions from the attendees, not all of which could be answered in the available time. We are very grateful for the contribution by Noni and her team in organising this fascinating Forum and also the leadership of Keith Govias, the Signatory Steering Group (SSG) Chair. The last HBGW webinar will be held on 2 December and I would encourage all of our Fellows and trainees to attend. HBGW is certainly ending the year on a high note.
The virtual Australian and New Zealand Society of Occupational Medicine (ANZSOM) 2020 Annual Scientific Meeting (ASM), with AFOEM providing scientific support, is fast approaching, now only a week away. The dates are from Thursday,19 to Sunday, 22 November. The organisers have arranged a terrific program with a wide range of interesting topics. The virtual worksite visits should be a highlight. I would like to encourage all of our Fellows and trainees to register for this ASM, if you have not already done so. Further details about the program and registration can be found on ANZSOM’s website
I’d also like to welcome back Lisa Helson, as our Executive Officer at AFOEM. Lisa was in the role early in the year, but then helped out at the Faculty of Rehabilitation Medicine office for a time to fill a gap there, but she has now returned to AFOEM, after our interim Executive Officer, Shauna Duffy, decided to leave the College. We are delighted to have Lisa back and this should provide some very welcome stability to the AFOEM head office as 2020 draws to a close and we head into 2021.
Finally, as always, we welcome contributions from our Fellows and trainees for our monthly eBulletins. Please let us know of any news items you would like to have included in a future edition. The AFOEM email is AFOEM@racp.edu.au
Professor Malcolm Sim
AFOEM Fellows interview series
This series provides insight into the careers of retired and actively serving physicians in occupational medicine. I am very privileged and extremely humbled to continue to meet inspiring colleagues. On this occasion I had the pleasure of talking to Dr Ian Gardner (AFOEM Past president, 1996-1998 and 2000-2002).
Dr Farhan Shahzad, Consultant Occupational and Environmental Medicine, Sydney
An interview with Dr Ian Gardner
Farhan: Welcome Ian, please tell us a little about your personal life, early training and how you developed an interest in occupational and environmental medicine?
Ian Gardner: I am a Queenslander who graduated in 1975 in Medicine from the University of Queensland, and then worked for three years as Medical Superintendent with the right of private practice at Clermont in Central Queensland.
In 1980, I received an offer from Alcoa of Australia to be their inaugural medical officer with the world's biggest alumina refinery at Pinjarra, WA. I soon realised that I needed some formal postgraduate training in occupational health.
So, I enrolled part-time in biostatistics and epidemiology at the WA Institute of Technology, now known as Curtin University. Alcoa had promised to send me to the University of Dundee in 1982 for what was then the world's best short course in occupational medicine. Unfortunately, the world alumina market crashed in late 1981 so that opportunity was no longer on the table. I made an on the spot decision to resign. I applied to Professor David Ferguson for an admission to the Master of Public Health (MPH) degree at Sydney Uni in '82 and received a partial credit for the academic work I had done with WAIT.
A few months after commencing the MPH course in Sydney, I was offered a position as Medical Officer for ICI Australia in Sydney. ICI agreed to allow me to complete my MPH studies (fully paid). At the time, ICI was one of the southern hemisphere's biggest manufacturing companies with products encompassing petrochemicals, fertilisers, explosives, pesticides, animal and human medicines, paints, fibres, plastics, solvents and chlorine. My four years with ICI Australia gave me very comprehensive training in occupational health. My MPH thesis was based on Lead work at DULUX, an ICI subsidiary.
In late 1985, I was head hunted for a brand-new position as Managing Physician with IBM Australia. This was during a time when the repetitive strain injury (RSI) epidemic was running rampant and the IBM Corporation was desperately worried. After a five-month training and development assignment in Japan, I was subsequently offered the Senior Managing Physician role with IBM Asia Pacific in Tokyo. We moved back to Japan, and for nearly four years I was responsible for the health, safety, medical and environment for IBM in the entire Asia Pacific. It included 19 countries, 50,000 employees and around 1,500 expatriates.
I returned to Australia in 1991 and resumed my very strong involvement in the American College of OEM as well as the old Australasian College of Occupational Medicine (ACOM).
After leaving IBM in 1998, I went into a full-time consulting practice which included pro bono work for the Workers Health Centre, a trade union affiliated medical centre in Western Sydney. It gave me credibility with the Unions and the Labor party which was of enormous assistance in my later appointments to many government roles as I was able to show a ‘balanced professional practice’.
Between 2001 and 2015, I worked for the Department of Defence as Senior Consultant in OEM. An extraordinary job!
In 2015, I was offered the position of Chief Health Officer and Principal Medical Adviser with the Department of Veterans Affairs (DVA) in Canberra. I knew the DVA system intimately because of my long involvement with Defence. I remained in this role until mid-2019 when I decided to semi retire and move back to Queensland.
Farhan: That’s so interesting Ian, what is keeping you busy these days?
Ian Gardner: In the last 20 years, I've done massively more work in the environmental space than occupational – yet find them both interesting. I'm currently doing a large amount of consulting work in the COVID-19 space.
I've been particularly interested in an emerging area of critical occupational health importance which is that of engineered nanomaterials. Managed to get a short article published in Nature Nanotechnology.
Farhan: What’s your message for trainees and fellow colleagues?
Ian Gardner: This is my 40th year in occupational medicine. The best career advice I received came from the IBM chairman, John Akers. He told me that my main job was to do two things. They were ‘do what's right’ and ‘keep us out of trouble’. If you stick to that, everything else falls into place!
ANZSOM Annual Scientific Meeting (Virtual ASM)
The Australian and New Zealand Society of Occupational Medicine (ANZSOM) invites you to their 2020 Annual Scientific Meeting, 'Exploring the new normal in workplace health' to be held virtually from Thursday, 19 to Sunday, 22 November 2020.
Reflecting the current priorities in workplace health, the program will feature three sessions devoted to COVID-19 risks and management, with a Keynote Address from Professor Brett Sutton, Victoria’s Chief Health Officer.
We will also offer virtual site visits for the first time, an online Journal Club and a range of topical presentations, all designed to get you involved.
For more information and to register, visit the ANZSOM website
The location for the 2021 RACP Congress has been unveiled and it is…everywhere.
Spread over six cities, two countries and streaming live, it has never been easier to attend.
Under the theme of ‘Transformation, adapting for the future’, RACP Congress 2021 will explore diverse topics that address ideas of transforming the way we deliver healthcare, how we look after ourselves in a connected age and what we need to know to prepare ourselves and our practice to remain relevant.
Call for abstracts for the 2021 RACP Congress
Abstract submissions are now being welcomed for the 2021 RACP Congress series. Submissions must be received for review no later than Wednesday, 23 December 2020. Accepted abstracts will be published in the Internal Medicine Journal/Journal of Paediatrics and Child Health journals supplements so don’t miss this opportunity.
Find out more
Updated version of the COVID-19 Guidance for Workplace Risk Management is now available
The updated version of the original AFOEM Guidance COVID-19 document on workplace risk management published in late July 2020 is now available to download
The original AFOEM Guidance COVID-19 document on workplace risk management has been updated to reflect the rapidly evolving advice on the use of personal protective equipment (PPE) for healthcare and aged care workers and the extremely concerning rates of occupationally-acquired infections amongst these workers in Victoria. The changes made bring this guidance document in line with current advice on PPE for healthcare and aged care workers and with the College’s latest statements on PPE. This updated version has been reviewed and endorsed by the RACP COVID-19 Expert Reference Group and by the College Policy & Advocacy Executive Committee (CPAC-EC).
AFOEM and the Thoracic Society of Australia and New Zealand (TSANZ) have undertaken extensive work to build a foundation of knowledge on Accelerated Silicosis. As there is limited knowledge on the disease at the present, AFOEM and TSANZ are advocating for the creation of government-funded health surveillance and disease registries necessary to support workers who have been exposed. AFOEM and TSANZ are also requesting industry regulators take urgent action to address silicosis as it continues to put workers’ lives at risk. For more information about this work please visit the RACP website
Share your views on climate change and health: Climate and Health Alliance survey
We invite you to participate in a survey on climate change and health run by the Climate and Health Alliance in collaboration with Monash University.
This survey is open to all RACP Adult Medicine Division and Chapter members and members of the Faculties of Public Health Medicine, Occupational and Environmental Medicine and Rehabilitation Medicine based in Australia.
The survey is being sent to health professionals across Australia and is assessing their:
- views on climate change as a human health issue
- willingness and ability to communicate the health impacts of climate change.
We encourage you to participate in the survey – regardless of the focus of your work – because your participation will help us understand our members' needs and interests in this area.
The survey is confidential, administered online and open until Monday, 30 November 2020. The survey should take approximately 25 minutes to complete.
If you have questions or concerns, please do not hesitate to contact the Climate and Health Alliance at firstname.lastname@example.org.
Dust and Respiratory Health Forum
The University of Queensland are holding a Dust and Respiratory Health Forum on 3 December 2020. The Forum will explore advancements in the management of dust and mine dust lung diseases.
The Forum will feature a range of expert speakers from organisations including The University of Queensland, The University of Illinois Chicago, The University of New South Wales, Resources Safety & Health Queensland and The Wesley Hospital. There will be opening addresses from Commissioner Kate Du Preez and Sustainable Minerals Institute (SMI) Director Neville Plint.
The forum will be held in a hybrid format, both in person and online via Zoom. With COVID-19 restrictions there are a limited number of people allowed in person, so register early to secure a spot.
Notifiable Dust Lung Disease Register inaugural annual report 2019-2020
Queensland Health has released its Notifiable Dust Lung Disease Register inaugural annual report 2019-2020.
The report includes new cases of notifiable dust lung diseases given to the Notifiable Dust Lung Disease Register during its first year of operations (from 1 July 2019 to 30 June 2020). The full report, further information about the Queensland Notifiable Dust Lung Disease Register and contact details for Register staff are available on Queensland Health's website
Health Benefits of Good Work Webinar Series
AFOEM’s Health Benefits of Good Work Signatory Steering Group are running a series of webinars on COVID-19.
The second webinar took place on 2 November 2020 on the topic: Returning the workforce back into the workplace considerations from a mental health, WHS and productivity perspective.
The webinar covered three key areas:
- effective leadership skills
- understanding WH&S obligations as an employer
- silver Linings of COVID 19.
The third and final webinar of the series is scheduled for Wednesday, 2 December 2020 from 1pm to 2pm AEDT, 3pm to 4pm NZDT. Registration details will be made available soon.
The topic for this webinar is: How to support employees with workers compensation injuries with a return back into the workplace (mental health and physical considerations).
Speakers are Corrinne Hutton, Robin Chase and Keith Govias as Chair.
Health Benefits of Good Work Forum
AFOEM’s Health Benefits of Good Work ran a free virtual forum on 11 November 2020 titled 'Promoting the Health Benefits of Good Work during COVID-19'.
Presentations and speakers included:
Rachel Palmer spoke about promoting the HBGW for the younger and ageing workforce and those returning from parental leave during COVID-19.
Cathy Oddie presented on domestic violence and employers' WH&S obligations for employees working from home.
Sara Pazell discussed considerations around work design during COVID 19.
RACP President's Indigenous Congress Prize
The RACP President's Indigenous Congress Prize
is open to medical students, junior medical officers and RACP trainees who identify as Aboriginal, Torres Strait Islander or Māori. The selected applicant will receive support to attend RACP Congress 2021 to gain educational and networking opportunities and exposure to career pathways within the College.
Please encourage anyone you know who is eligible to apply before the deadline on Monday, 1 February 2021.
RACP Indigenous Health Scholarships
AFOEM is proud to offer the 2021 Indigenous Health Scholarships for Occupational and Environmental Medicine as part of the RACP Indigenous Health Scholarship Program.
The program aims to support medical graduates and RACP trainees who identify as Aboriginal, Torres Strait Islander or Māori on their chosen career path to becoming a physician. The scholarships provide a funded pathway through Basic, Advanced, Faculty or Chapter Training in Australia and/or Aotearoa New Zealand.
Several scholarships are available for 2021, including:
- College Indigenous Australian and Māori Health Scholarship
- Aboriginal and Torres Strait Islander Health Scholarship
- Aotearoa Māori Health Scholarship
- Aotearoa New Zealand Pacific Islander Health Scholarship
- Indigenous Australian and Māori Health Scholarship for Paediatrics and Child Health
Applications close on Monday, 30 November 2020.
Further details on these scholarships are available on the scholarship webpage.
Quality and safety online course
Quality and safety are central to the delivery of healthcare in Australia and Aotearoa New Zealand. Our Quality and Safety online course has been designed to help you identify and overcome common quality and safety challenges. Don’t have time to complete the whole course? That’s no problem. Our courses are designed to enable you to dip in and out, or just do the parts that are relevant to you.
We understand you’re busy, so we’ve made sure RACP Online Learning resources are accessible anywhere and optimised for mobile on-the-go learning.
To support the implementation of Evolve recommendations in clinical practice, we have launched a series of case studies exploring a clinical scenario based on one of the Evolve recommendations on low-value care. The aim of the case studies is to support Fellows and trainees to build an understanding of low-value care within their specialty and act as a tool for clinical educators and supervisors. We have had approval to turn some of our case studies into an RACP Q-stream. Q-streams are an interactive learning platform, which disseminates case studies via email at spaced intervals. To support this we are seeking enthusiastic Fellows and trainees to lead the development of case studies.
Outlined below is a list of Evolve recommendations we think would be appropriate. If you would like to be involved, email Gemma Altinger, Program Implementation Lead at email@example.com to receive more information on the case study development process.
|Rehabilitation medicine (AFRM)
Recommendation 3: Do not use Mini Mental State Examination as the only tool to assess cognitive deficit in acquired brain injury.
|Geriatric medicine (ANZSGM)
Recommendation 1: Do not use antipsychotics as the first choice to treat behavioural and psychological symptoms of dementia.
Recommendation 2: Do not prescribe benzodiazepines or other sedative-hypnotics to older adults as first choice for insomnia, agitation or delirium.
Recommendation 4: Do not prescribe medication without conducting a drug regimen review or IMSANZ Recommendation 1: Avoid medication-related harm in older patients (>65 years) receiving five or more regularly used medicines by performing a complete medication review and deprescribing whenever appropriate or combined.
|Addiction medicine (AChAM)
||Recommendation 1: Do not undertake elective withdrawal management in the absence of a post-withdrawal treatment plan agreed with the patient that addresses their substance use and related health issues.
Recommendation 3: Do not deprescribe or stop opioid treatment in a patient with concurrent chronic pain and opioid dependence without considering the impact on morbidity and mortality from discontinuation of opioid medications.
|Occupational and environmental medicine (AFOEM)
Recommendation 2: Do not request X-rays or other imaging for acute non-specific low back pain, unless there are red flags or other clinical reasons to suspect serious spinal pathology.
|Immunology and allergy (ASCIA)
Recommendation 1: Do not use antihistamines to treat anaphylaxis – prompt administration of adrenaline (epinephrine) is the only treatment for anaphylaxis.
Recommendation 1: Do not perform imaging of the carotid arteries for simple faints
Recommendation 5: Do not routinely recommend surgery for a narrowing carotid artery (>50% stenosis) that has not caused symptoms.
|Dermatological Society (NZDS)
||Recommendation 5: Do not routinely use topical antibiotics on a surgical wound.
Recommendation 3: Do not routinely order chest X-rays for the diagnosis of asthma in children.
Recommendation 5: Do not routinely order abdominal X-rays for the diagnosis of non-specific abdominal pain in children.
|Sexual health medicine (AChSHM)
||Recommendation 5: Do not prescribe testosterone therapy to older men except in confirmed cases of hypogonadism.
Pomegranate Health podcast Ep64: Big pharma and the people’s vaccine
This is part two in our series on global public health and focuses on the impact of intellectual property (IP) laws on the development and distribution of pharmaceuticals. The COVID-19 pandemic has stimulated a frenzy of vaccine development never seen before, but also examples of hoarding, price hikes and vaccine nationalism. The crisis has brought together scores of governments, manufactures and philanthropic organisations to pool research outcomes and patents, but the response from big pharma has been mixed.
In this podcast, we’ll discuss where the IP rules have come from and where exceptions are sometimes made for public health emergencies. We also discuss how pooled procurement mechanisms and advanced market commitments can help get drugs and vaccines to populations in developing countries and whether COVID-19 can prompt a permanent change to the existing IP regime.
- Dr Owain Williams (University of Leeds)
- Associate Professor Peter Hill AFPHM (University of Queensland)
- Dr Deborah Gleeson (La Trobe University)
New advocacy resource on minimum unit pricing for alcohol
As part of the ongoing campaign to reduce the many harms of alcohol, the RACP has produced an advocacy resource on minimum unit pricing (MUP) for alcohol. MUP sets a floor price below which a fixed volume of alcohol cannot be sold to the public. MUP is designed to increase the price of the cheapest alcohol; since heavier alcohol users typically consume cheaper products, the policy effectively targets price increases at heavier users. As the heavy use of the cheap, high-alcohol products drives health inequalities, MUP is also likely to be an effective mechanism for reducing these inequalities.
The new information sheet on MUP shows there is a robust evidence base supporting its effectiveness at reducing alcohol consumption and harm. Growing evidence from Scotland, Russia and the Northern Territory (NT) has shown that MUP can be effective across diverse settings. The success of the RACP-supported (reference 1, reference 2) measure in the NT, recently corroborated by an independent evaluation, further underlines its appeal to other jurisdictions in Australia.
RACP endorses Australian Research Alliance for Children and Youth (ARACY) campaign for universal free early childhood services
Following strong support from Paediatrics & Child Health Division Fellows, the RACP has endorsed a new ARACY campaign which calls on the Government to invest in a universally accessible, high‐quality early learning and childcare system, delivered by a skilled and supported workforce. The open letter at the centre of the campaign outlines how investment in a universally accessible childcare system will support the important role played by families and set Australia up for an equitable and sustainable future in the COVID-19 pandemic recovery.
This campaign aligns with the PCHD position statement on Early childhood: the importance of the early years position statement which notes that there is ample research supporting the benefits of early childhood education on child development. It recommends that the Australian Government:
- commits to long-term, sustainable funding of the National Partnership on Universal Access to Early Childhood Education beyond 2020–21 for all Australian children and expands it to starting at three years old
- continues to fund early childhood education through the Child Care Subsidy program.
Changes to the Authorised Prescriber Scheme
On 24 July 2020, the Therapeutic Goods Administration (TGA) implemented a change to the Authorised Prescriber Scheme to streamline the application process for medicines considered to have an established history of use in Australia. The application form and process have been updated for medical practitioners to apply under the new arrangements.
This change removes the requirement for Human Research Ethics Committee (HREC) approval or specialist college endorsement to be submitted to the TGA in circumstances where the medical practitioner is applying to become an Authorised Prescriber of medicines specified in subregulation 12B(1B) of the Therapeutic Goods Regulations 1990. A printable version is available on the TGA website of a list of medicines with an established history of use. The Human Ethics Research Committee (HREC) or institutional approval may still be required to use certain ‘unapproved’ therapeutic goods within an institution, such as a hospital. Medical practitioners will need to liaise with the relevant institution to confirm the requirements.
A medical practitioner will also still need to obtain prior HREC approval or specialist college endorsement for products that are not included in subregulation 12B(1B) of the Therapeutic Goods Regulations 1990. Further details on applying for approval/endorsement are available in the guidance document ‘Authorised Prescriber Scheme – Guidance for Medical Practitioners, Human Research Ethics Committees, Specialist Colleges and Sponsors’.
Information and access to the Special Access Scheme & Authorised Prescriber Online System to submit applications is available on the Authorised Prescribers webpage.
New member benefit: discounted Microsoft Surface devices and accessories
ASI Solutions has created an exclusive portal for our Australian members to purchase Microsoft Surface devices and accessories at group discount pricing.
Log in to MYRACP and click through to the ASI portal. You will need to set up an account with ASI Solutions to access the offer.
If you have any questions please contact ASI Solutions.
The business range of Surface devices is uniquely placed to support you in your everyday work and professional learning.
Coupled with your choice of the right software and cloud services to meet your unique needs, the beautifully-engineered Surface devices deliver secure access to information and allow deep communication and collaboration wherever you are.
Please note the RACP is publishing this offer as a service to members. Such publication does not constitute endorsement.
*Offers only available to current RACP members that are Australian residents.
ASI Solutions respects your privacy. Please read their online Privacy Statement.
Save on computers, phones, TVs and more with exclusive offer at the JB Hi-Fi Corporate Benefits program. Australia’s largest retailer of consumer electronics, the portal never sleeps and provides you access to great offers 24 hours, seven days a week.
Start shopping for Christmas presents or prepare for the summer sports season with these November specials.
- Samsung Series 4 HW-T450 200W 2.1 Channel Soundbar, (433961) – Now $285.00
- Hisense 55S8 Series 8 55' 4K UHD Smart TV  (444439) – Now $884.00
- Dell Inspiron 3505 15.6' Full HD Laptop (512GB) (475758) – Now $982.00
- Apple Airpods with Charging Case (2nd Gen) (381102) – Now $220.00
Visit your Member Advantage benefits platform to find these offers and more.
Terms and conditions apply to JB HiFi Solutions products, Member Advantage members only. Promotion Offer pricing valid until 30 November 2020.
Conferences and events
The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses.
Go to the events list at any time to see what events are coming up.
For career opportunities, view all positions vacant on the RACP website.
Expressions of Interest
Join the Regional and Rural Physician Working Group
Check the Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you.