Web guidelines link EHS to up-to-date information

True value of document lies in Internet access

Because they are published on the Internet, comprehensive guidelines written specifically for hospital employee health services provide a wealth of continuously updated information, including easily accessed links to relevant recommendations and regulations from federal agencies and data from other occupational health-related Web sites.

"Guidelines for Employee Health Services in Health Care Facilities" is a collaborative effort from the Medical Center Occupational Health (MCOH) Section of the American College of Occupational and Environmental Medicine (ACOEM) in Arlington Heights, IL. The project was coordinated by Geoff Kelafant, MD, MSPH, FACOEM, medical director of the Sarah Bush Lincoln Health Center’s Occupational Health Department in Mattoon, IL, and vice chairman/ communications chairman of the MCOH Section.

Kelafant, who also is editor of the Occupa tional and Environmental Medicine Resources World Wide Web site on the Internet, took on the job as guidelines editor to update ACOEM’s 1986 recommendations.1

Guidelines written specifically for employee health services in any format are scarce, with the only other comprehensive document also more than 10 years old with no revision in process.2

"The field of employee health has changed significantly since then," Kelafant says, "so we either had to update our guidelines or disavow any knowledge of their existence. We felt that technology had gotten to the point where we could do this ourselves and make the new guidelines widely available, which is why we chose the Internet route."

Revisions began in 1995, and as many as eight drafts of the document were placed on a password-protected Web site for comments. The resulting guidelines provide an unprecedented opportunity for employee health professionals to have instant access to the most current government, agency, and other authoritative documents related to their field via the World Wide Web. (See editor’s note at end of article for the guidelines’ World Wide Web address.)

Generic guidelines have broad application

The guidelines provide a framework for all the tasks and responsibilities typically undertaken by employee health services in medical institutions, rather than being a prescriptive document.

"They show what you need, and don’t spend a great deal of time telling you how to do it day-to-day," Kelafant explains. "We tried to keep the guidelines generic so they would apply to a 20-bed hospital as well as a 1,000-bed tertiary-care facility. We don’t describe exactly how responsibilities are to be carried out, because many of them change frequently, such as TB surveillance or bloodborne pathogens. Also, all institutions are set up differently, and it may be impossible to do things the same way everywhere."

The guidelines’ sections cover a broad range of information, including employee health objectives, workplace hazards, medical assessment, immunizations, infection control, environmental surveillance, health promotion, disaster planning, employee assistance and substance abuse, legal issues, record keeping, quality improvement, accreditation, and communication.

Hypertext links are provided throughout to the most current documents issued by the Centers for Disease Control and Prevention, the Occupational Safety and Health Administration, and the National Institute for Occupational Safety and Health, as well as other federal agencies, academic institutions, and additional relevant sites, so information can be accessed instantly with the click of a mouse.

As a bonus to its readers, Hospital Employee Health will provide all of its subscribers with printed copies of the guidelines, which were approved by ACOEM in April 1998. Subscribers will receive copies of the guidelines shortly after receiving the January issue.

The document may be published later this year in other occupational health journals, but Kelafant emphasizes that its unique value lies in Internet access, which allows the guidelines to be revised several times per month as federal regulations change, new information comes on-line, and other EHPs suggest changes or additions.

Not lagging behind, for once

"That’s the beauty of using this. It remains a collaborative, living document," he says. "We still welcome additions to it. We also feel very strongly that people should have access to the source documents. Usually, occupational medicine lags behind in technology because there aren’t many of us, but in the case of hospital employee health and occupational health in general, much of the information people need is all on-line because it’s from OSHA or NIOSH or CDC. So for once, in our specialty, we are in the right place at the right time."

(Editor’s note: A printed version of the guidelines will be provided to all Hospital Employee Health subscribers by mail in the coming month. However, to take maximum advantage of the guidelines’ constant updating, as well as the many hypertext links to source documents, access the guidelines regularly on the World Wide Web at: www.occenvmed.net/ehsg/.

Kelafant also moderates an Internet mailing list that specializes in hospital occupational health issues. For information on joining the list, go to: www.occenvmed.net/mcoh/listinfo.htm.

To suggest changes or additions to the guidelines, send e-mail to: kelafant@occenvmed.net.)


1. Guidelines for employee health services in health care institutions. Committee on Medical Center Employee Occupational Health, American Occupational Medicine Association. J Occup Med 1986; 28:518-523.

2. U.S. Department of Health and Human Services, National Institute for Occupational Safety and Health. Guidelines for Protecting the Safety and Health of Health Care Workers. Washington, DC: NIOSH; 1988.