Occupational health through primary health care clinics in Singapore

The training of primary health care workers in occupational health is important for the provision of occupational health care to the workforce. In Singapore, over 400 Designated Factory Doctors, mostly general practitioners, have been trained. Occupational health is also incorporated in the training of family medicine trainees. Referral centres for cases of suspected work-related diseases are also available. Two specialist occupational health clinics function within Government polyclinics serving the large working population in Singapore. One such clinic operates every Wednesday morning at the Jurong Polyclinic. In the last four years, 485 patients with work-related complaints were seen. There were 268 cases (55%) of occupational skin disease, 74 patients (15%) with respiratory complaints, 38 patients (8%) with acute toxic exposures and 36 patients (7%) with musculoskeletal complaints. Three hundred and forty-nine of the referrals (72%) came from the Jurong Polyclinic doctors, with small numbers from other polyclinics and neighbouring private practitioners. The experience gained in conducting this clinic demonstrated that significant numbers of diseases seen at the polyclinic are work-related in varying degrees. Hence, there is a need for the further development of occupational health care delivery within the primary health care system. This can be achieved by improving occupational health training for all primary health care workers, providing an occupational health resource person at primary health care centres, and raising the awareness of such referral facilities in occupational medicine.