It is fi ve years since the publication of the fourth
edition, and the new century has proved a period
of enormous change in the fi eld of occupational
health. The importance of trying to reduce the costs
of health care has led the government to continue
to look closely at the need for prevention in respect
of work - related disease, and to consider how occupational
health cover might be extended to more
workers, especially those in small and medium -
sized enterprises. The Health and Safety Executive,
which in the past tended to concentrate mainly on
workplace accidents, has been directing its attention
more and more towards health issues, in particular
to stress. The need to reduce the numbers
of people claiming incapacity benefi t led the government
to appoint Dame Carol Black to undertake
a review of the health of Britain ’ s working age
population. Her recommendations raise the profi le
of occupational health professionals, and when
implemented will extend the scope of occupational
health advice to primary care practitioners in the
NHS