Author: DP@CastleMedical

Do you know ALM is more prevalent in Asians and among people with darker skin?

Acral lentiginous Melanoma (ALM) is a distinct subtype of melanoma that typically manifests on the palms, soles, or beneath the nails. While less prevalent in the general populace, ALM stands as the most common melanoma variant in individuals with darker skin tones and those of Asian descent. Nevertheless, it can occur across all skin types.

Unlike the majority of skin cancers, acral melanoma does not result from UV radiation exposure. It manifests in regions of the body that are not typically exposed to sunlight. Acral melanoma development can be triggered by various factors such as trauma, environmental influences, and family history.

What are the early signs of melanoma?

The most common symptoms of melanoma are:

• The most common symptoms of melanoma are:
• a new spot on the skin, or a spot that is changing in size, shape or colour
• moles that have features of the ‘ABCDE rule’:
  • Asymmetry: the 2 sides of the mole do not match
  • Border irregularity: the mole has irregular edges
  • Colour: the mole is not the same colour throughout
  • Diameter: the mole is wider than about 6 mm (although some melanomas are smaller than this)
  • Evolving: the mole has changed in size, shape, colour or texture during the past few weeks or months
• a sore that does not heal
• itching, scaling, bleeding, oozing, swelling or pain, in or around a mole
• spread of pigment from a spot into the surrounding skin.

What is squamous cell carcinoma?

Squamous cell carcinoma (SCC) is one of the most prevalent types of skin cancer, though it is generally considered less lethal than melanoma. However, if left untreated, SCC can potentially spread to distant organs. Annually, people in Australia die from aggressive forms of SCCs.

What are the types of squamous cell carcinoma?

Some common types of SCC include:

• Oral SCC: SCC can develop in the mucous membranes of the mouth, including the lips, tongue, gums, and inside the cheeks. It can present as white or red patches, ulcers, or lumps.
• SCC in situ (Bowen’s disease): This is an early form of SCC where abnormal cells are confined to the epidermis (outer layer of the skin) or mucous membranes without invading deeper tissues.

Excessive noise is not only disruptive but also has the potential to inflict permanent damage by harming the delicate hearing mechanism in the inner ear.

Workers most affected by a noisy work environment are those in industries and job roles where exposure to high noise levels is common. These include construction workers, manufacturing employees, miners, agricultural workers, industrial maintenance personnel, and transportation drivers.

How much noise is too much noise?

Loud noises, especially those exceeding 85 decibels (dB), can damage the sensitive hair cells in your inner ear. These cells are crucial for transmitting sound signals to your brain. Prolonged exposure to high noise levels can lead to noise-induced hearing loss, a permanent and irreversible condition. The gradual loss of hearing can affect your quality of life and productivity, both at work and in your personal life.

Recognising the signs of hearing damage

The top five signs that your hearing may be affected or that you could be experiencing hearing loss include:

1. Difficulty understanding conversations: Struggling to follow or participate in conversations, especially in noisy or crowded settings.
2. Frequent requests for repetition: Frequently asking people to repeat themselves or speak more loudly.
3. Tinnitus: Experiencing ringing, buzzing or hissing sounds in your ears when there is no external source of the noise.
4. Increasing the volume: Needing to increase the volume on the television, radio, or electronic devices to hear clearly, and receiving comments from others that it’s too loud.
5. Social withdrawal: Avoiding social gatherings, parties or meetings because of difficulty in hearing and understanding what’s being said and experiencing social isolation.

Protecting your hearing at work

1. Use hearing protection: If your workplace is noisy, your employer should provide hearing protection. Make sure to wear them consistently.
2. Take breaks: Whenever possible, step away from loud areas from short breaks to give your ears a rest.
3. Limit personal exposure: Be mindful of your exposure to loud noises outside of work too. Activities with high volume can further contribute to hearing damage. For instance, use hearing protection when mowing the lawn, using the chainsaw or at a concert.

Audiometric Testing
Regular audiometric testing can help identify any hearing loss early on. This testing is often required in certain industries and is a proactive step towards preserving your hearing.

Your hearing is a valuable asset and it’s essential to take steps to protect it, especially if you work in a noisy environment. It is also important to note that the NSW government has approved the commencement of Clause 58 – Audiometric Testing under the Work Health and Safety (WHS) Regulation from 1 January 2024.

Therefore, businesses that require workers to frequently use hearing protection as a control measure for noise that exceeds the exposure standard will have to provide hearing tests. For new workers, a baseline hearing test must be completed within three months of commencing their employment. The worker must then get a follow-up monitoring hearing test at least every two years during their employment.

Making an appointment

Our Workplace Health Services Team can assist with hearing test appointments. For enquiries and/or to book an appointment please call 02 8865 0633 or email workplacehealth@chmc.com.au

From 1 January 2024, Clause 58 of Work Health and Safety Regulations 2017 requires employers in NSW to provide hearing tests (audiometric tests) to workers who are exposed to hazardous noise and frequently use hearing protection in the workplace.

Employers must provide employees with audiometry testing:

• Within three months of starting their employment (baseline test)
• and a follow-up test at least every two years.

Click here to find out more about the latest hearing test requirements and penalties.

Our Audiometric Test Procedure

Audiometric testing is a standard and non-invasive procedure to evaluate hearing capabilities and identify any hearing impairment.

Step 1: Preparation

• We will provide a questionnaire/consent form for your employee to fill out prior to testing
• Their medical history and any current hearing concerns are taken into consideration

Step 2: Otoscopy

A visual examination of the ear canal using an otoscope may be conducted to check for any obstructions or issues in the ear.

Step 3: Pure-Tone Audiometry

• You will be seated in a soundproof booth or quiet room.
• Headphones will be provided.
• You will be presented with a series of pure-tone sounds at various frequencies (measured in Hertz, Hz) and intensities (measured in decibels, dB) to each ear separately.
• You will respond by indicating when you hear a tone, typically by pressing a button, raising a hand, or providing a verbal response.

Step 4: Results

• The results of the audiometric test will be analysed to determine the individual’s hearing thresholds and any potential hearing loss.
• Results are typically plotted on an audiogram, which is a visual representation of an individual’s hearing abilities.
• A copy of the results will be sent to your employer

Audiometry Screening with CMMP

Castle Medical provides integrated workplace health solutions. We view hearing test programs as an opportunity to engage with your employees, enhancing both their well-being and your organisation’s overall health.

On-site hearing test service is also available. For more information about our workplace health services, visit our website or email our WHS team at workplacehealth@chmc.com.au

Firstly, do you know what you are signing up for?

News media has recently explored a story about a chain of medical centres in NSW, QLD, and VIC that has recently changed their policy. The medical centres will only bulk-bill if patients sign up for their app and rewards program; otherwise, there will be a $90 out-of-pocket fee.

Let’s start from the very beginning…

What is a rewards program?

The purpose of a rewards program is to incentivise and foster customer loyalty and engagement with a business or brand. A loyalty program encourages customers to return, spend more, and interact further with the brand.

This results in higher customer retention, word-of-mouth promotion, and the gathering of valuable data. Additionally, such programs establish an emotional bond, offer a competitive advantage, and enable customised marketing strategies, ultimately boosting customer satisfaction and brand success.

Why do rewards programs in the healthcare industry present ethical concerns?

As a business, we clearly understand the benefits of a rewards program from both a business perspective and a customer standpoint. However, due to the nature of the business that we are in, it raises ethical questions.

Here are some of the reasons why:

1. Quality of care: Your healthcare providers might be encouraged to prioritise profit over patient well-being.
2. Patient Autonomy: The rewards program could impel you to make medical decisions based on incentives rather than your own health needs and preferences.
3. Professional integrity: Healthcare providers are bound by ethical codes to give precedence to patient health and well-being. As such, a rewards program could result in a conflict of interest where the monetary rewards conflict with medical assessment.
4. Equity and access: Rewards programs could potentially discriminate in favour of specific patients. This could potentially worsen any inequalities in healthcare. Those who lack the means to afford certain medical interventions and hesitate to join the program due to data privacy concerns might miss out on certain healthcare benefits.
5. Doctor-patient relationship: Incorporating rewards programs could change the dynamic between doctors and patients. The introduction of financial incentives can tarnish trust and create opportunities for potential misuse.
6. Confidentiality and Privacy: Patient data collection raises privacy concerns. The information could be shared or exploited for marketing purposes without proper consent or security parameters.
7. Diversion from fundamental principles: Healthcare is fundamentally about patient health, and the introduction of incentives might divert attention from this core value, resulting in compromised patient care.

Will Castle Medical be implementing a rewards program?

Here’s the good news. You will not need to sign up for a rewards program to receive the health care you deserve.

We are committed to upholding ethical values in all aspects of our operations.

At Castle Medical, we offer:

1. Patient-centered care: We prioritise patients’ individual needs and well-being, including their preferences, values, and concerns in all medical decisions and treatment plans. We ensure that you receive personalised, considerate, and effective medical treatments.
2. Transparency: We provide clear and honest information about medical conditions, treatment options, costs, and potential risks so that you can make informed decisions about your health.
3. Informed consent: We ensure that you understand and agree to all aspects of your care, including risks and benefits before proceeding with any treatment or procedure.
4. Confidentiality and privacy: We protect patient information and maintain strict confidentiality to secure your privacy and trust.
5. Evidence-based practice: We utilise Clinimetrix – a practice intelligence software that helps GPs provide tailored medical solutions aimed at improving your quality of life and accelerating your recovery.
6. Prevent Conflicts of Interest: We aim to give precedence to the health of our patients above any financial benefit or personal interests and make clinical decisions based entirely on medical requirements.
7. Fairness and Absence of Bias: We treat all patients with respect, regardless of their origin, race, gender, or other personal attributes and beliefs.
8. Professionalism: We maintain professional levels of behaviour, honesty, and ethical conduct in every interaction involving patients, staff, and colleagues.
9. Open communication: We encourage honest and open conversations between you and your healthcare provider, cultivating trust and co-operation throughout the decision-making process.
10. Accountability and responsibility: Our medical centres take responsibility for medical decisions, outcomes, and mistakes, and addresses any concerns or errors in a transparent and responsible manner.

At Castle Medical, our commitment to fairness, responsibility, and ongoing enhancement is paramount. Our goal is to establish our medical centres as a trusted healthcare provider that prioritises ethical principles in every facet of our work.

If you have any concerns, please speak to your local practice manager today. You can reach us at ask-mp@castlemedical.com.au.

It is essential to understand the importance of pre-employment medicals and how they contribute to the well-being and productivity not only of your employees, but your business.

You may have a candidate in mind for a role in your company. You have read their resume, checked their references, and have had one or maybe even two interviews. But have you considered a pre-employment medical to see if they are the right fit and can physically complete the required tasks?

Your new apprentice electrician could be colour-blind. Does the office worker you want to hire have high blood pressure which requires managing? Perhaps your new storeman has a history of back problems of which you are not aware.

Don’t be part of the statistics, adding to the ongoing costs to your business due to injuries that may have been preventable.
Pre-employment medicals assess whether the candidate is the right fit for the role to ensure the correct work environment from the start.

Invest in the financial health of your business with pre-employment medicals.

Workplace injuries cost Australian businesses $61.8 million each year. Also, between 2003 to 2011, the state with the highest number of injuries by location is NSW followed by Queensland, Victoria, WA, SA and NT, according to Safe Work Australia.

Occupations with the leading number of claims between 2011-2020 are:

• Labourers
• Technicians and Trade Workers
• Community and Personal Service Workers
• Machinery Operators and Drivers
• Professionals
• Sales workers

Industries with highest number of claims are:

• Health Care and Social Assistance
• Manufacturing
• Construction
• Transport, Postal and Warehousing
• Public Administration and Safety
• Retail Trade

Every on-site injury causes lost time and insurance premiums to increase, adding to the ongoing costs of doing business.

The actual cost of workplace injuries is not limited to the expense of wage replacement, medical and insurance fees. The indirect costs of workplace injuries include workplace disruption, lost productivity, management time, liability issues, increased injury risk and damaged reputation.

In onboarding your new employees, we offer a range of workplace health services from standard to comprehensive pre-employment medicals, musculoskeletal assessments, audiograms, spirometry screening and instant drug and alcohol testing.

We are here to support your business and staff well after you have onboarded the right candidates.

In today’s dynamic corporate world, maintaining the health and wellbeing of employees is essential for businesses to thrive.

Vaccination Programs

Maintaining a healthy workforce often involves protecting your employees from preventable illnesses with immunisation against infectious diseases to help safeguard their wellbeing.

Our medical centres offer vaccination programs such as Hepatitis, Q fever, travel vaccinations and influenza to both new and existing employees tailored to the specific needs of their role. We also offer onsite influenza vaccinations at your workplace (seasonal).

These vaccination programs help businesses significantly reduce absenteeism due to illnesses and create a safer work environment.

Mental Health and Staff Wellness Workshops (Castle Medical Only)

¹Research shows that absence rates are about five percent higher among workers who report being in poor mental health. In addition, job conditions are related to both presenteeism and absenteeism even after accounting for workers’ self-reported mental health status.

Mental illness is now the leading cause of sickness, absence, and long-term work incapacity in Australia. Each year, $543 million is paid in workers’ compensation for work-related mental health conditions, according to Safe Work Australia².

We recognise the importance of education and empowerment when it comes to employee health and wellbeing. Therefore, at Castle Medical, we have mental health experts who conduct interactive health and wellness workshops that cover a range of topics from stress management to mental health awareness.

The future of work is employee wellbeing. These workshops help create a productive and healthy workplace which increases employment engagement and motivation to reach goals.

These workshops can be conducted either on-site or virtually.

Workplace Health Services are available at CM Marsden Park and CHMC The Mall.

Services available at CHMC The Mall only:

• Rail assessments – Category 1, 2 & 3
• Executive Health Assessments

🌐 For more information, please visit our website at CHMC WHS or CMMP WHS
📲 To speak with our friendly workplace health services team, please email workplacehealth@chmc.com.au or call (02) 8865 0633.

Ref¹: https://www.sciencedirect.com/science/article/abs/pii/S0927537116301506
Ref²: https://www.healthierwork.act.gov.au/home/mentally-healthier-workplaces/