Wednesday 7 October 2009
Occupational Health

2009 UIMC Scientific Congress and General Assembly (Utrecht, Netherlands, 23 – 25 September)

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The annual UIMC (International Union of Railway Medical Services) congress was hosted by Dutch railways NS and their medical service from 23 to 25 September 2009 in Utrecht.
Meetings of the Management Committee, Scientific Congress and General Assembly were held during the congress, as well as a technical visit.

The UIMC Management Committee met on the morning of 23 September, and is composed as follows:

- Chairman: Dr P.-A. Voumard, CFF/SBB
- General Secretary: Dr C. Cothereau, SNCF
- Vice-Chairman : Dr G. Palma, FS
- Treasurer: Dr M. Banadiam, Team Prevent (Austria)
- Secretary: Dr D Whelan, CIE
- Other members: Dr M. Tucek, CD; Dr O. Foss, NSB; Dr. V. K. Ramteke, IR.

The committee discussed the UIMC accounts, the requests for admission to be submitted to the assembly, the status of working groups and the medical database, points which were subsequently presented to the General Assembly.
Several companies had expressed an interest in joining UIMC, in particular South African railways and the Slovak railways’ new medical service. UIMC hoped to welcome them as new members in 2010.

The General Assembly on 25 September, chaired by Dr Voumard, was attended by 33 representatives from 24 UIMC members.
The Vice-Chairman Dr G. Palma, head of the working group mandated by CER (Community of European Railways), and the Chairman Dr P.-A. Voumard informed members that they had attended the ERA (European Rail Agency) experts’ meeting in Lille on 8 September in their capacity as independent medical experts. The aim was to clarify the medical criteria deriving from EU Directive 2007/59 on the introduction of a European locomotive driver’s licence. The UIMC / CER group had been mandated to continue its work with the aim of passing clear legislation regarding locomotive drivers’ medical aptitude.
Then, Dr. M. Sherif Zulhemma from Egypt gave a presentation concerning the association of Arab Railway Doctors. This association was keen to forge close links with UIMC, and these links would be fostered by the UIMC Management Committee. The first evidence of this is that the UIMC 2010 General Assembly and Scientific Conference would be held in Morocco.

The technical visit on 24 September had been to NS’s state-of-the-art passenger rolling stock maintenance and repair workshops in Haarlem. This visit was followed by a gala dinner at the Railway museum where the participants were welcomed by Mr. Blockland, the NS Human Resource Director.

The scientific conference was opened by Ms Marga Thissen, Manager for Occupational Health in NS Group, who described NS as a modern dynamic railway constantly developing new innovations to meet the demands of a modern society as well as exploring new markets, new business and contributing to a sustainable environment. She further outlined the role of the NS Occupational Health Service as dedicated to the control of absenteeism and the maintenance of a healthy workforce through the implementation of various lifestyle programmes.

Next Mr. Dick Spreeuwers, the Managing Director of the Academic Medical Centre, introduced a company called Polikliniek Mens en Arbeid (P.M.A.). This was a multidisciplinary specialist occupational medicine out-patient clinic which had been developed to provide occupational health assessments not only for NS but also for other Dutch industries. The chief factor in its success was close interaction between the occupational physicians within NS, the specialist physicians in the hospital system and P.M.A. occupational physicians, which enabled a high quality occupational medical service to be provided.

The next paper concerned a presentation by Dr. Jaap van Dijk, an Academic Medical Centre expert (P.M.A.). Dr. van Dijk’s paper related to a mathematical model for estimating the risk of causing harm to others using the product of the distance or time spent behind the wheel, multiplied by the type of vehicle, multiplied by the individual risk of sudden incapacity, multiplied by the probability that incapacitation will result in an injury-producing accident. This model could be equally applied to road safety as well as railway safety-critical personnel. Dr. van Dijk finally emphasised that its main role was in supporting a national standard of risk assessment.

There followed a paper by Dr. Frits Holleman, a clinical diabetologist, on the implications of a diagnosis of diabetes mellitus for railway safety personnel. He outlined that hypoglycaemia (low blood sugar) was the main risk for safety-critical staff. He pointed out that most employees with type-2 diabetes were fit to undertake safety-critical roles, including locomotive driving, because severe hypoglycaemia is rare in type-2 diabetes and hypoglycaemic unawareness is uncommon. He further pointed out that it was possible to risk-stratify the tendency to hypoglycaemia based on age, type of treatment, duration of diabetes/insulin treatment and the presence of hypoglycaemic unawareness.

The next paper was presented by Professor W. Drechsler and Dr. Bas Sorgdrager on hearing standards for locomotive drivers. They suggested that a new standard should be set which would include measurements of hearing at 4 kilohertz as well as for the existing levels of 1 and 2 kilohertz. Testing at 4 kilohertz was particularly important for the understanding of speech in a noisy environment. They also suggested new standards for each ear individually and for the difference in both ears, since the symmetry of hearing is important in hearing warning signals.

Finally, Dr. Evelien van Valen (neuropsychologist) outlined the role of neuropsychological testing in the assessment of fitness for safety-critical duties. The chief function of such testing was to specify the nature and severity of the cognitive and emotional deficits which can result from physical diseases of the brain such as strokes or T.I.A. This leads to better diagnosis, prognosis, advice and occupational outcomes for employees.

For the first time, internationally-recognised medical experts were invited to participate in the Scientific Congress, the aim being to promote high-quality medical standards.

The second session of the Scientific Conference was held on 25 September.

The first presentation was given by Professor J. Barbur, Professor of Optics and Visual Science at City University, London, who had developed a new method for accurate assessment of colour vision. The colour assessment and diagnosis test (C.A.D.) established whether an applicant had colour vision within the normal range, identified the class and severity of any colour vision deficiency and indicated whether an applicant’s colour vision met the minimum requirements. This test had been developed on behalf of the Civil Aviation Authority but also had important implications for other modes of transport, including rail transport. This test could have significant implications for the rail industry, and could reduce the number of unjustified rejections based on existing colour vision tests.

The next paper by Dr. T.J. McCormick, President of the North American Railway Doctors’ Association, outlined the effects of monocular vision on peripheral vision and stereopsis, which gives objects their three dimensional quality and is important for close work e.g. threading a needle. He also pointed out that depth perception is generally not affected by monocular vision.

Dr. Hans Knut Otterstad from the Norwegian Railway Service then presented a paper on the development of body mass index among train drivers and conductors over the last ten years. This paper demonstrated an epidemic of obesity within the younger age cohort within Norwegian Railways and society in general, and outlined the strategies that should be employed by the railways to reduce the impact of obesity in railway operations.

Next, Mr. Sterling Smith outlined a joint initiative between the International Labour Organisation, the International Transport Workers’ Federation and the International Union of Railways to prepare a toolkit on HIV/AIDS in railway companies. Mr. Smith outlined that HIV/AIDS was the fourth biggest cause of death in the world today and that it was the leading cause of death in sub-Saharan Africa. He highlighted that railway medical services therefore had a key role to play in the prevention of HIV and AIDS through the provision of education, counselling and advice among their employees. UIMC said it was prepared to support the ILO in this area, since some of its members were disproportionately affected by AIDS compared to others.

The next presentation was by Dr. Nezha Barakat, the Chief Medical Officer of the Moroccan Railways’ Medical Service. She outlined a health promotion initiative within the Moroccan Railways to help employees stop smoking and promised a further updated report on the results of such an initiative in a railway company in twelve months’ time, when the UIMC would visit Morocco.

Dr. St. Claire from the Occupational Health Unit of London Transport then presented a paper on the management of sickness-related absence. She outlined a programme for the management of such absence and demonstrated that with such a systematic approach a significant impact can be made on absenteeism among railway staff. She estimated a return on investment of £3.5 for every £1 (sterling) spent on the service.

The next paper was by Dr. D. Whelan, Chief Medical Officer of the Irish Railways, who presented a paper on the impact of online suicides on locomotive drivers’ psychological health. He compared the results of the Irish treatment programme with those of his colleagues at London Underground, Scandinavian Railways and French Railways. A lively discussion ensued following his presentation which led to an agreement on a standardised approach to this problem.

The Scientific Conference’s final presentation was given by Dr. G. Ceccarelli from Rete Ferroviaria Italiana on the Italian law pertaining to the control of alcohol and drug abuse by safety-critical workers, including railway workers. He outlined the programme introduced at RFI to comply with this law and offered it as a template for other railways which were considering the introduction of such a policy.

The Chairman Dr. Pierre Voumard (SBB) then closed the UIMC Scientific Conference, urging his fellow doctors to utilise the information and new knowledge they had acquired during the three days of the Conference to develop and enhance the medical service in their own railways in the interests of enhanced employee wellbeing and improved public safety.

At the invitation of ONCF (Moroccan Railways), the UIMC 2010 Scientific Congress and General Assembly will take place from 22 to 24 September 2010 in Marrakesh.

For more information please contact Meryem Belhaj:

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The UIMC Management Committee(The UIMC Management Committee
The UIMC Management Committee
The UIMC Scientific Congress(The UIMC Scientific Congress
The UIMC Scientific Congress
Dr Pierre Voumard at the floor(Dr Pierre Voumard at the floor
Dr Pierre Voumard at the floor