AFOEM eBulletin – 24 July 2020

A message from your President

I am writing this post from lockdown central in inner Melbourne during the current second wave of COVID-19 cases in Victoria. This has been a very worrying development after a strong response to the first wave brought the number of daily cases down to less than 20 cases a day for almost two months. Even more worrying, and a reason why this second wave is proving more difficult to manage, is that almost all cases are from community transmission. During the first wave, the majority of cases were in international arrivals, either by plane or ship. The current surge in Victoria, of between 200 and 400 new cases per day has been a stark contrast to the rest of Australia and Aotearoa New Zealand, where community transmission has been negligible. The one exception is Sydney, where there are early signs of a possible second wave.

The rapid increase in community transmission in Melbourne over the past month has focused attention on cases in workplaces. This includes many cases in several hospitals, but also among workers in aged care, the meat industry, schools, retail distribution centres, call centres, a law firm and others. This has resulted in stage three restrictions being reimposed in Melbourne and from this week the mandatory wearing of face coverings for everyone outside their home, including those in the workplace. To help deal with this second wave, the Victorian Department of Health and Human Services put out a call to Victorian based Fellows and trainees of AFOEM to assist with the workplace aspects. Pleasingly, we have had a great response from our members to step-up and assist our public health and other medical colleagues and demonstrate the important contribution we can make to manage this crisis. This work includes contact tracing of affected workers and developing guidance for minimising risk of COVID-19 in a variety of workplaces.

In parallel with this ‘on the ground’ support being provided by AFOEM members in Victoria, our Faculty Policy & Advisory Committee has continued to develop COVID-19 guidance material to assist workplaces more broadly. The latest document outlines a risk assessment and risk management framework, including the application of the hierarchy of controls. The focus is on higher order controls, with face masks and other PPE being lower order controls, as for any other workplace hazard. Special thanks need to go to Dr Neil Westphalen, who led the development of this paper. We have also had input from the Infection Control Expert Group of the Commonwealth Department of Health to ensure our guidance is consistent with their advice. The document is now available from the RACP COVID 19 webpage under the 'the Clinical advice for clinicians'. Lastly, we are finalising dates for our three webinars to be held for the Health Benefits of Good Work signatories with the theme ‘Returning to a new normal: Managing return-to-work in a post COVID-19 world’. These webinars provide us with an opportunity for AFOEM to influence the industry response to COVID-19, not just in terms of infection control, but the mental health and return to work aspects.

The other webinars currently available to AFOEM members are those being arranged in place of the cancelled RACP Congress, which was to be held in Melbourne in May. I hope you are taking advantage of the wide variety of topics on offer. I listened in to the silicosis webinar held on 20 July, which was convened by Dr Graeme Edwards, who has been a leading light in the program to reduce the risks of this disease and a member of the National Silicosis Taskforce. The panel Graeme convened included Dr Ryan Hoy, a respiratory physician who has managed many of these cases in Melbourne and is also a key figure in our silicosis research program at Monash. Other panel members spoke about occupational hygiene aspects, government approaches and rheumatological aspects. There are still many question marks about this disease, and we look forward to the next steps of the taskforce, including establishment of a national registry and research funding.

The first meeting of the new AFOEM Council will be held next Tuesday, 28 July, preceded by a planning session on Monday, 27 July to help shape the next two years of AFOEM activities. Both will be held virtually by Zoom and we are now becoming experts at the use of this technology, after initial reservations about whether it would be interactive enough. Muting and unmuting at the appropriate times still remains somewhat of a challenge for me! I’m looking forward to the interchange of ideas at the planning session and Council meeting. The new Council has a great mix of returning and new members to ensure continuity with activities over the past two years, while bringing in new ideas and perspectives.  

I’d like to finish off by thanking our AFOEM Executive Officer, Lisa Helson, who will be leaving us next week. Lisa has only been with us for a short time, but she has been a great support to me and other AFOEM office bearers, especially under the trying working conditions of COVID-19. We have been very fortunate to have had an amazing group of very organised EOs working with AFOEM Presidents, Council and other members over the past few years and Lisa has been no exception. I’m sure I speak for us all in wishing her well in her post-AFOEM activities.

Malcolm

Professor Malcolm Sim
AFOEM President

AFOEM interview series

This series provides insight into the careers of retired and actively serving physicians in occupational medicine. 

On this occasion, I had the pleasure of speaking with Professor Niki Ellis, the Inaugural AFOEM President from 1992 to 1994.

Dr Farhan Shahzad MBBS, FAFOEM, Consultant Occupational Physician, Sydney

An interview with Professor Niki Ellis FAFOEM, FAFPHM

Farhan: Professor Niki Ellis thanks for joining and sharing with us. Please tell us about yourself, your personal life, education and career?

Professor Ellis: I turned 65 this year. I don’t think of myself as transitioning to retirement but in reality, I suppose I am. I sit on boards in the fields of workplace mental health, responsible drinking, evidence and implementation science and higher education, and am still the Work for Health advisor for Comcare. All of which I enjoy.  

I was brought up in Launceston, in a museum. It taught me the importance of history, which I bring to my work as an occupational and public health physician. I am not from a medical family, but my Father was very interested in medicine and encouraged me. Later he helped me with research and editing for my book, Work and Health: Management in Australia and New Zealand, published by Oxford University Press in 2001.  

Farhan: Let’s talk about your achievements, memories and the many highlights of your career.

Professor Ellis: I did my degree in Tasmania and then went to work at the Royal Hobart Hospital. I was accepted into the Basic Physician Training program, but wasn’t enjoying clinical work. Never could I have imagined then that I would end up being a Director on the RACP Board for two years, from 2018 to 2020. Serendipitously in 1980 my consultant for a term in oncology was Allan Foster, a former Minister for Health. He could see I was unhappy and suggested public health. He picked up the phone and rang the Director of Public Health at the time. “I want you to give this young girlie a job,” he said, and so my career began.  

My career has taken me through the state and commonwealth public service, to the private sector with my own consultancy with offices in Sydney, Melbourne and, for a while, Brisbane. I sold it to PricewaterhouseCoopers and worked with them, before going to London and working at London Southbank University and the Department of Health on health services innovation, and the Wellcome Trust Centre for the History of Medicine. I came back to Australia to an academic career setting up the Centre for Military and Veterans’ Health at the University of Queensland and then the Institute for Safety and Recovery Research at Monash. A highlight in 2007 was making the television series Stressbuster.  

Until recently all my mentors have been men – Helen McArdle’s father was my first boss, Martin Bicevskis was a knowledgeable and kind peer in those early years, Peter Brooks and Steve Leeder demonstrated the power of advocacy AND research. There wasn’t a well-established career pathway, I followed my nose.

Farhan: Do you have a message for trainees and Fellow occupational physicians?

Professor Ellis: My advice to younger occupational physicians would be the emerging landscape of the integrated approach to WHS is opening up horizons for us. Don’t wait to be asked, create new roles for our profession.  

Telehealth in Australia now

Telehealth was brand new for many of us, and now some of us might be getting rusty on the fundamental considerations to make before, during and after telehealth consultations.

The animated overview below will be included in a new online learning resource that will be available on eLearning.racp.edu.au and will also include Aotearoa New Zealand specific information.

 

Calling all artists and performers – the Online Congress Series Fringe Experience

At RACP Congress 2019, we launched the inaugural Fringe Experience. The Fringe Experience provided an opportunity for you to share the things you do outside of your life as healthcare professionals. We were treated to singing performances, poetry readings, art displays and yoga sessions, highlighting the extraordinary talents of our members and focusing on some of the things you do to look after your health and wellbeing.

Although we are unable to meet face-to-face this year, we are still excited to bring you the Online Congress Series Fringe Experience.

Are you a budding musician, singer, dancer or mime artist? Send us a short video that we can share on the Online Congress Series platform.

Do you dabble with paints, pencils or crayons? Send us a picture of your artwork to include in our Fringe Experience Gallery on social media.

Perhaps you have an eye for photography. We would love to share your work.

The Online Congress Fringe Experience will include meditations, yoga sessions, creative writing workshops and more.

If you would like to lead a session, showcase your art or share a performance email racpcongress@racp.edu.au with a short synopsis of your presentation. We will work with you to bring your ideas to life.

Faculty awards and prizes

The AFOEM President’s Awards recognise outstanding contributions to the Faculty in the following areas:

  • education, training and assessment
  • policy and advocacy
  • trainee commitment.

Nominations are open from 10 August 2020 to 12 October 2020.

The AFOEM Essay Prize is open to medical students or interns in their first year after graduation. This prize is awarded for the best essay written additional to curriculum requirements, or the best research project or assignment on any topic in the fields of occupational or environmental health. Applications are open from 1 August to 30 October 2020.

Details about these prizes are available on the RACP Foundation website.

College medals and awards

Nominations are now open for the following College prizes which acknowledge outstanding contributions and achievements made by Fellows and trainees in their respective fields:

  • The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of the RACP and its members.
  • The College Medal is aligned to the College motto hominum servire saluti. It is awarded to a Fellow who makes a significant contribution to medical specialist practice, healthcare and/or health of community through physician activities.
  • International Medal recognises a member who has provided outstanding service in developing countries.
  • Medal for Clinical Service in Rural and Remote Areas recognises a Fellow who has provided outstanding clinical service in rural and remote areas of Australia or Aotearoa New Zealand.
  • Mentor of the Year Award recognises a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training.
  • Trainee of the Year recognises a trainee who has made an outstanding contribution to College, community and trainee activities.
  • The Eric Susman Prize is awarded by the College to a Fellow for the best contribution to the knowledge of internal medicine.

Successful nominees are presented a medal at the RACP Congress and receive full Congress registration, return economy airfares and up to three nights’ accommodation.

Full details are available on the RACP Foundation webpage.

Trainee Research Awards 2020

Applications for the Trainee Research Awards are now open for trainees and New Fellows undertaking post-Fellowship training.

The Trainee Research Awards provide a valuable opportunity for trainees to present their research at an Australian regional or Aotearoa New Zealand event. The best presenters from each local event are invited to be part of the Research and Innovation stream at the RACP Congress. Selected representatives will also receive complimentary registration, return airfares and accommodation for up to three nights to attend the RACP Congress.

Please send your abstract submissions or inquiries by email to your respective regional RACP offices.
Applications close on Monday, 31 August 2020.

AFOEM CPD session – PPE and Rebooting NRL in 2020

Webinar: Saturday, 1 August from 10am to 12pm.

Join us for this special Dr Steven Ng Memorial CPD Presentation with the following presenters:

  • Professor Raina MacIntyre presenting 'PPE for healthcare workers during the COVID-19 pandemic'
  • Associate Professor David Heslop presenting 'Integrated Public Health and Occupational and Environmental Medicine during the COVID-19 crisis – rebooting the NRL 2020 Premiership Season'. 

When: Saturday, 1 August 2020 from 10am to 12pm.
RSVP: Register online

RACP a key player in the historic decision on pregnancy warnings on alcoholic products

On 17 July 2020, the Ministerial Forum on Food Regulation made the important and pioneering decision to endorse evidence-based pregnancy warning labels on alcohol products, safeguarding the health and wellbeing of children in Australia and New Zealand. The College has welcomed the Ministerial decision to adopt effective pregnancy warning labels on alcohol products.

The evidence-based labelling scheme recommended earlier in the year by Food Standards Australia and New Zealand was finally endorsed by a majority of ministers after a more than decade-long campaign for mandatory, clear and effective labelling of alcoholic products with warnings that indicate drinking while pregnant harms the unborn baby.

Special thanks in this long, coordinated campaign go to Professor John Wilson, Associate Professor Mark Lane, Professor Elizabeth Elliott, Dr Adrian Reynolds, Dr George Laking, Professor Judy Savige, Dr Rajesh Raj and Associate Professor Nick Buckmaster, as well as to our dedicated partners at the Foundation for Alcohol Research and Education. It’s truly impossible to overestimate the positive effects of this critical public health win.

In the words of Professor Elliott, “The colour of this label is particularly important. Red attracts attention and conveys warning, the black text on white background is easily legible, the pictogram is understandable even by non-English speaking populations, and the words ‘alcohol can cause lifelong harm to your baby’ give a clear warning message.”

As Professor Wilson stressed, “The RACP has been supportive of pregnancy warning labels on alcohol products for over a decade – it’s great to see Australian and New Zealand governments now take this necessary step for the health of our communities.”

Join the College Policy and Advocacy Council Executive Committee

Do you want to be a force for change and be recognised and listened to by health policy decision-makers and be an advocate for patients’ interests? Apply to be a member of the Executive Committee for our College Policy and Advocacy Council.

There are seven vacant positions open on the College Policy and Advocacy Council Executive Committee (CPAC EC). Members of the CPAC EC make a real difference by tackling emerging policy and advocacy issues to improve the quality and safety of healthcare in Australia and Aotearoa New Zealand.

Find out more

Prioritising Health 2020 Northern Territory election statement

The Northern Territory Regional Committee has developed an election statement to identify and advocate for its priority areas.

The statement makes NT-specific recommendations on the following priority areas, drawn from existing approved College positions:

  • climate change and health
  • alcohol
  • Indigenous health
  • acute rheumatic fever (ARF) and rheumatic heart disease (RHD)
  • raising the age of criminal responsibility.

This statement is designed to position the Committee and the RACP for post-election advocacy on these priorities over the next four-year term. 

Hotline for health professionals caring for people with disabilities during COVID-19

The Australian Government Department of Health has set up a telephone advisory service providing specialised clinical advice for health professionals involved in the care of people with disability during the COVID-19 pandemic.

Some people with disability may become very anxious in these situations and require reasonable adjustments to their healthcare to ensure they receive either COVID-19 testing or treatment with minimum distress.

Health professionals can call the service on 1800 131 330 between 7am and 11pm (AEST), seven days a week.

Thank you to RACP Fellows who are involved in this service.

Health & Safety Association New Zealand online symposium on workplace health and safety

It’s the conference you have when you’re not having a conference. As you know, the Health & Safety Association New Zealand (HASANZ) Conference has been postponed until September 2021, but we’re still committed to providing you with learning and networking opportunities. On Thursday, 27 August HASANZ is holding an online symposium on workplace health and safety. Please join your health and safety colleagues around the country, businesses, policy-makers and educators for an afternoon of provocative and topical presentations and discussions with plenty of opportunities for participation. 

Program highlights include:

  • Keynote address: Managing health and safety in the virtual workplace 
  • Case study: How Countdown Supermarkets managed health and safety through COVID-19
  • Panel discussion: Impacts of cannabis legalisation on workplace health and safety – what a potential 'yes' outcome from the September referendum might mean
  • Keynote address: Psychological first aid – identifying psychological distress in ourselves and others and building awareness and support strategies for mental health. 

Register now for a special discounted rate of $129 plus GST for HASANZ members.

All delegates go in the draw for a free registration (excluding dinner) to HASANZ CONFERENCE 2021.

For more information and registration visit the HASANZ website.

Recent changes to the National Immunisation Program

From 1 July 2020, additional at-risk groups are eligible for funded vaccines under the National Immunisation Program.

Changes relate to the following vaccines:

  • Pneumococcal vaccine (Pneumovax 23 and Prevenar 13) – there are changes to the timing and type of pneumococcal vaccine for some at risk groups, adults and Aboriginal people.
  • Meningococcal B vaccine (Bexsero) – this vaccine is now funded for Aboriginal children and some at risk people.
  • Meningococcal ACWY (Nimerix) – this vaccine is now funded for some additional at-risk people.
  • Haemophilus influenzae type b (ACT-Hib) – this vaccine is now funded for some additional at-risk people.

For further details on the changes, please visit the NSW Health website.

AFOEM committee casual vacancies

Calling AFOEM Fellows and trainees, there are a number of casual vacancies on AFOEM Committees. The links below provide full details and information on how to apply for these positions:

New Pomegranate podcast: Ep60 and Ep61: Delirium

Detection and Causes: In the first part of these podcasts we talk about the presentations and detection of delirium. We also go through some of the medical risk factors, including dementia, infection and metabolic disorders like hypercalcaemia. Even more common than these precipitants, are a host of drugs that can alter cognition or increase agitation by their anti-cholinergic properties. Importantly, we hear Adam Kwok describe his experience as the carer of a patient going through the trauma of three bouts of delirium, and the challenges of care.

Prevention and Management: In the second part we discuss a host of environmental triggers that are highly modifiable. Anything that contributes to a person’s disorientation and discomfort can increase the likelihood of a delirium episode. While a lot of these factors are compounded in elderly and frail patients, it’s important not to be fatalistic. Delirium can be reversed in a majority of patients by non-pharmacological means, though there are no medications indicated for treatment anywhere in the world. Antipsychotics should only be considered in patients experiencing severe distress intractable by other means as they are associated with many adverse side effects.

Guests

  • Adam Kwok
  • Professor Meera Agar FRACP, FAChPM (Liverpool Hospital, UTS)
  • Professor Gideon Caplan FRACP (Director of Geriatric Medicine, Prince of Wales Hospital, UNSW)

Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode and reading the resources.

Subscribe to Pomegranate Health in Apple iTunesSpotify or any Android podcasting app.

Listen to Ep60: Delirium Part 1 – Detection and Causes

Listen to Ep61: Delirium Part 2 – Prevention and Management

Expressions of Interest  

Check the Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you. 

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.

Career opportunities 

For career opportunities, view all positions vacant on the RACP website.

AFOEM contact details

Member enquiries
Phone: 
(AUS) 1300 69 7227
Phone: 
(NZ) 0508 69 7227
Email: 
memberservices@racp.edu.au 

AFOEM Faculty enquiries (including Council and committees):

AFOEM Executive Officer
Phone: +61 2 8247 6251 
Email: afoem@racp.edu.au

AFOEM Health Benefits of Good Work (HBGW) enquiries:
Email: HBGW@racp.edu.au

AFOEM Education and Training enquiries:
Email: occenvmed@racp.edu.au

AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
Email: faculty.examinations@racp.edu.au

AFOEM training site accreditation inquiries:
Site Accreditation Unit
Email: accreditation@racp.edu.au

AFOEM CPD enquiries:
Email: mycpd@racp.edu.au
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