By Ketan Varia, Healthcare Connections Ltd
In the rail industry, even seemingly trivial side effects of medications such as drowsiness, dizziness or visual disturbance could have a catastrophic outcome for employees and the general public if workers are unaware of the dangers.
Under Railway Group Standard GE/RT8070 and support document GE/GN8570, rail organisations are required to ensure that employees report the use of prescribed and over-the-counter (OTC) medications to their supervisor or line-manager and that all staff have access to a competent medical authority to advise on their ability to carry out safety critical tasks.
It is well known that any medication, whether prescribed by a doctor, bought over-the-counter, via the internet or from a herbal or Chinese practitioner, can cause a range of side effects. Less well known is the fact that combinations of medicines can have even greater side effects when combined than individually.
This is caused by the medicines interacting with each other inside the human body. Even if an employee is stable on medication for a long term condition, the addition of a new (even short term) treatment has the potential to destabilise the existing treatment or cause new side effects through a drug interaction.
Any medication, whether taken orally, applied to the skin, inhaled or used in other ways carries the risk of side effects and possible interaction with other medication.
Some examples of more common side effects and interactions include:
- Decongestants for colds or flu may interact with certain medications taken to reduce blood pressure and can cause a sudden rise in blood pressure. This could lead to further ill health and the potential of stroke, raising the risk factor at work.
- Anti-histamines for hayfever or other allergies may cause drowsiness. When taken alongside other medications that cause drowsiness such as certain painkillers or anti-depressants, this side effect can be worse, a potentially deadly combination whilst performing safety critical duties.
- Anti-inflammatory medicines such as ibuprofen and diclofenac used to treat swelling and pain have the potential to worsen asthma, cause severe stomach irritation or nausea, and should be used with caution by individuals with high blood pressure, liver or kidney problems.
Experienced rail specialist pharmacists fully understand the need for the provision of accurate and timely medication advice and information for safety critical staff, coupled with good and effective links to occupational health.
Healthcare Connections is able to provide added occupational health benefits alongside sister company Chemist On Call’s medication review.
For example, a recent rail employee suffering back pain during the course of kidney dialysis treatment was made aware that the application of a muscle rub was most likely to be causing their potassium levels to increase, affecting their kidney function.
This clearly displays the need for a collaborative approach to medication whilst at work, and the wider occupational health and safety of the rail infrastructure.
