1. The Practical Aspects of Occupational Health for Eurotunnel across the Borders ARIOPS 2008 Dr Manuel Fernandes Occupational Physician

2. AGENDA Company structure Medical staffing Medical standards Medical examinations Management referrals Fitness to work Treatment Work-related health injuries Drugs and Alcohol Physicians duties

3. Eurotunnel Structure A Binational company A Joint Board of Directors One management Employees: 2/3 in France, 1/3 in the UK

4. Medical Staffing OHP 4 days 1.8 OHAs OHP 2 days 1.4 OHAs

5. Medical Standards Eurotunnel -highest standard taken as the baseline -commonality of standards/criteria -commonality of medical frequency

6. Medical Examinations Safety Critical Staff All safety critical staff -annually -OHP+OHA Night shift workers - 6 monthly -OHP+OHA -6 monthly -OHP +OHA All safety critical staff -annually -OHA -3 yearly -OHP+OHA

7. Medical Examinations Non Safety Critical Staff Annually -OHP + OHA Biannually (management) Only the OHP can certify fitness for work 3 Yearly -OHP+OHA OHP and OHA can certify fitness for work

8. Management Referrals OHP only GP has no say in fitness for work OHP /OHA GP may have a say in fitness for work

9. Fitness for work OHP only can certify fitness for work OHP/OHA can both certify fitness for work

10. Treatment OHP prescribes/gives medication/injections OHA gives OTC remedies OHP/OHA no treatment given

11. Work-related health injuries OHP reports to responsible body (CRAM/CPAM) OHA sees/is informed of everyone post accident with injury and reports cases to CRAM (social security external authority) that have received treatment externally. Internal treatment is recorded internally only. OHP reports to H&S manager who reports to the HSE

12. Drugs and Alcohol Legislation 2003 legislation equivalent to our Railway & Other Guided System regulations Railway & Other Guided System (ROGS) regulations

13. Drugs and Alcohol Safety-critical staff only Pre-placement For Cause Random All staff Pre-placement For cause Random

14. Drugs and Alcohol Pre-placement - OHP declares “unfit” For cause – OHP declares “unfit” “Random”- at discretion of OHP Pre-placement - OHP declares “unfit” For cause – OHP declares “unfit” Unannounced - to HR

15. Physicians duties Everything to do with “fitness for work” is at the discretion of the OHP OHP bound by legislation,HR practice and H&S responsibilities