Why Medicines Matter in the Workplace

Medicines used for the management or prevention of ill health are always prescribed with a balance of risks and benefits in mind. That’s why prescribing is a regulated process. However, even medicines available over the counter (OTC) for controlling symptoms like pain can be powerful drugs with significant side effects.

In 2015-16 around 50% of surveyed adults in the UK were prescribed at least one drug in the preceding week, with around 25% of adults taking three or more medicines. It’s likely that some people in your workforce are taking medicines, whether prescribed or over the counter. Why is this relevant to employers? Because medicines can affect how people function at work, and in some cases may increase vulnerability in certain workplace environments.

We’ve previously explored some hot topics within this theme, such as medical cannabis and weight loss medications. But the same principles around medicines at work apply to any drug, whether prescribed, bought OTC, or even sourced without a legitimate prescription.

The Science Behind It

The underlying principles relevant to considering the impact of medicines at work stem from the drug’s pharmacology:  how it’s absorbed, metabolised (processed), and excreted. Broadly, this can be divided into:

●       Pharmacodynamics: what the drug does to the body

●       Pharmacokinetics: what the body does to the drug

These principles explain why drugs affect people so differently. For example, someone with liver damage (the organ in the body that does lots of drug processing) may take longer to process the same dose of the same drug than someone healthy. Underlying science aside, when we look at medicines in the context of work, we can translate the pharmacology to two key practical aspects of medicines at work.

1. Administration

How does the individual take the medicine? Can they do this independently at work?For example, someone using injectable medication may need assistance from a healthcare professional, potentially affecting their working hours or ability to attend work when administering the medicine.

2. Side Effect Profile

Every drug has potential side effects, and the same medicine can affect different people in very different ways. Side effects such as fatigue and dizziness can have major implications for safety-critical roles.

The timing of side effects can also be relevant. Adjusting when a medication is taken, or modifying work hours or duties can sometimes help manage these effects. The time it takes for the body to clear a drug is also relevant when it comes to managing side effects. When drugs are cleared quickly the side effects don’t generally last as long.

One side effect to highlight is immunosuppression- when a drug weakens the immune system’s ability to fight infection. Some people are recommended by their treating clinicians to limit contact during particularly immunosuppressive medication regimes. Depending on the degree of immunosuppression, this may limit an individual’s ability to work safely in environments with higher infection risks, such as certain healthcare settings.

Managing Medicines at Work

So how should employers approach these issues?

It’s important to ensure that employers and employees understand their responsibilities regarding health at work. If someone experiences a change in health or medication that may affect their function, raising it in a confidential workplace discussion can help optimise support and protect the safety of everyone involved.

There are no simple rules that apply to the way a medicine could impact workplace function. In fact, two people on the same drug for the same reason can respond completely differently. Polypharmacy is a term used to describe when people take five or more medications. This comes with overlapping administration schedules and side effect profiles that can be even harder to navigate for the individual and their prescriber, let alone manage the workplace impact. Ultimately the complexity of modern pharmacology means that independent, individualised occupational health assessment is often the best way to ensure safe and fair management of medicines in the workplace. As occupational health is a clinically-led service, it may even be possible for the OH clinician to approach the treating clinician to discuss exploring alterations in treatment regimes where appropriate.

Practical advice

1- Make sure your workforce is aware that starting a new medicine could impact their occupational health. This applies to individual employees and managers that may be informed about medication changes by people on their teams.

2- Have the resources in place to signpost to an occupational health assessment when someone has a change in treatment.

3- Be ready to work with your occupational health clinician to think through role adjustments where necessary - sometimes a change in start time or changing around timings of duties can go a long way in managing side effects.

Here are some fictional case studies that pull together these principles.

Case 1: Mr A, Security Guard 

Mr A works from 4-10pm, and is awaiting a joint replacement. He takes an opioid-based painkiller around 4pm to manage pain that worsens later in the day. However, a few hours later he feels drowsy, affecting his ability to stay alert during his safety-critical shift.An occupational health assessment recommends moving his hours to 8am–2pm. This means the sedative effect that makes him feel drowsy no longer interferes with his work. After surgery and discontinuation of pain medication, he returns to his previous schedule.

Case 2: Ms B, Teacher

Ms B recently started antidepressant medication for low mood. Initially, she experiences increased anxiety and poor sleep. These are known early side effects of the drug she was prescribed, which often improve with time.

An occupational health assessment confirms she’s not at risk of self-harm but is struggling to concentrate due to fatigue and anxiety. She takes three weeks of sickness absence. When reassessed, her side effects have settled, and her mood has improved. She then returns to work gradually over two weeks, starting with administrative tasks before resuming full teaching duties.

Both of these case studies illustrate how important it is to get things right with medication changes and workplace duties. Both also show that it is possible to balance work, health and medication needs with the right support.

Next Steps

If you or someone in your team is managing medication, don’t navigate the workplace impact alone. Contact Insight Workplace Health for a confidential occupational health assessment and ensure safe, effective support for your workforce.