Well, while we present, we're going to present, return to work some principles and some best practices in Indonesia, Egypt, Saudi Arabia. And for me, it's a pleasure to be here with this small audience. So please, if you have any questions, we're happy to provide an answer. If we know the answer, we declare no conflict of interest. So I, I'm from Venezuela. I was born and raised there. I have lived in the U.S., I have lived in London, now I live in Italy. So we truly understand that every country, every, in the U.S., it seems like every state have their own legislation. So we have to take that in consideration. For example, in Saudi Arabia, alcohol is not allowed, not even drugs. There's like a penalty death, depending on if there's drug traffic or it's, so we don't have to worry about drug and alcohol test program. I used to run the drug and alcohol test in Venezuela and support in Latin America. So this is a very particular issue, for example, that in these countries, they don't have to have these programs. The Return to Work program, it's a collaborative, proactive process that we use to help injured workers or somebody that has a diagnosis and we have to adapt their physical and mental capacities to the workplace. So we have to have a plan, should stay that regular monitoring. Sometimes we have a patient that can start work partially and we have like a reduced work day or we have to adapt the activities. So it's not like, we don't, it's not a final word. When we provide recommendations, we have to continue monitoring the workplace and the patient, I mean the worker and his adaptation. Be consistent with the business goal and business goal departments of the department. And we have to specify that gradual increase in both hours and duties will occur. It's very important to take in consideration what the patient wants. We have had, I have been in presence of many workers that they hate their job. And that, we have to take that in consideration. Sometimes they don't want to return to work. Probably you have had that experience, right? And sometimes that creates more complication because if somebody doesn't want to return to work, it's going to be more challenging. And in occupational medicine, we know that we have simulators and de-simulators. Is that the right word? So for example, when we're doing an assessment, a pre-employment assessment, usually the patient is a hundred percent healthy. They hide if there are any issues because they're afraid not to get the job. So, or we have, when we, there's an incident, an accident and a diagnosis work related. Some of our workers can exaggerate the symptoms. It's a reality. We have to have a plan. And by the way, I want to make a break right here. Yesterday, I heard something that I like it a lot and I will use it forever. They said a short presentation is better than a long presentation. So I will try to summarize because today is the last day. We have been here for four days. So we have to detail where the employee can obtain additional help. Not every company, not every workplace have an EAP service. I would like to know out of this audience in your company, do you have provide EAP services to your employees? Just one, two, three, four, five. So that would be like 40% maybe of this audience. But we are in the United States of America and most of the people that are here present working in corporations, probably big corporations, more than 250 employees. So we have to respect employees' dignity, privacy and personal information. The United States, it's more strict than other countries. During the pandemic, I moved to Europe. So I have noticed in several countries that COVID was not a big issue. There was not a huge confidentiality. In American companies, it was a secret. You cannot say who was the person who initiated the, what's the name, track, when we do the contact tracing. It was a secret. You couldn't say who was the first person who started with the symptoms. In other countries, oh, she has COVID and everybody knows. I don't know how it works. So I think this is very important. Employees' dignity, privacy and personal information confidential. So these are some of the challenges for the return to work process, delay in reporting an injury, previous performance issues, or a person with poor self-efficacy. And when the job security is in jeopardy, that's a big challenge. We live in an inclusive and diverse world, but we do understand that at the workplace, one of the main interests of a business is to make money. And that creates some sort of a conflict. Here is the sphere of influence. So physical pain, social factors, attitudes, and belief. Some people don't want to continue in that job and their pain is a subconscious alarm to keep them away from the job, psychological distress and illness behavior. Here are some benefits of an effective return to work because increases the chances of meeting a target, promotes an increased sense of teamwork. And I don't know if, I would like to know in your companies, do you have like diversity and inclusion programs or campaigns? Please raise your hands. One, two, three, four. Like around 40%. I'm glad to see that. Promote a supportive and positive safety culture, enables early intervention, great understanding of rehabilitation process. We have seen, I was impressed about all the possibilities that we will have in the future. For example, not with this, you know, I'm forgetting my English, processes. Is that correct? Now with AI, they're like doing this, a lot of advances. But not every country have like rehab or places for inclusion with people with disabilities, motor disabilities. I loved when Kenji showed this tango couple dancing with the lady in a wheelchair. That's real inclusion. So now people are more focusing on the function than the disability. That's lovely. Increase the likelihood of positive performance review meeting with increased productivity and that's what everybody wants. When we have a person with a disability and he's away from work, it's a huge loss for the company. And we have to keep in mind productivity because a business is there in place and the owners, they're very much focused on productivity. So that's, we have to include this word in our vocabulary when implementing an effective return to work process. And it has a demonstrated leadership role within the company for us, occupational physicians in our team. And finally, increased confidence and problem solving. So this is a chart that shows the multidisciplinary team that is involved. Human resources is essential because they have to adapt the payroll. In some countries, they provide full payment when somebody's away from work. In other countries, they don't pay. So they have to know how to pay, how much do they have to pay, all the administrative process. If they have to find a new replacement, human resources is the one who's going to help us. So we have a patient provider, case manager, insurance claim manager, treating practitioner, other employees who have a good relationship with the employee. And sometimes it's unknown. I have been in a workplace that the secretary was a male, the assistant. He is, I think he doesn't like his job. He's all the time on a sick leave and nobody knows when he's going to come back. Knowing when the person is going to come back is essential because you can program your activities based on that information. Family member of the employees, union official, payroll, legal team, all these multidisciplinary teams are involved in the return to work process. So to finalize, keep in mind communication and information, that's essential. Sometimes I have been in situations when the worker doesn't show up and after two days the medical information arrives to the medical department. So communication is essential. Regular contact made between the supervisor and employee and here can be tricky. In the US, it's not like the supervisor can call the employee at home. How do you feel? Because it can be considered harassment. Is that correct? In other countries, it's actually well seen and expected that the supervisor call the direct report and say, how do you feel? Because it's kind. So that's essential to keep in mind culture background. Transparency in the system, timing is really important and we should clarify the employee's medical restrictions, what they cannot do if they, if we have to be specific. And one of the challenges I have received in my medical practice is like a medical report from somebody, from a doctor that says he cannot lift weight, he cannot work sitting down, he cannot work standing up. So what do we do? Put a bed in the workplace? Have you received these kind of reports, recommendations? So that has to be very specific. How many hours this person can be sitting down? How many hours or minutes this person has to be standing up? How often do they have to make a break? So we have to ask for the rehabilitation leader or the medical, the doctor who's treating the patient, we have, we have to request to be very specific. Provide suitable duties and hours for the employees to follow. And some, this sounds very nice in paper, but in reality it's very complex. And should clearly detail how the program will operate. So communication. If we don't understand the paperwork, let's call the treating physician and ask for clarifications. And approval for the employees treating doctor to return to work plan. I know in the U.S. for the occupational physician to call the treating physician, we have to have an informed consent. In Latin America, the occupational physician can call the treating physician and no problem because it's a colleague's conversation. Can anybody confirm if in the U.S. it's like that? You have to have the informed consent from the worker to call with it, to call the treating physician? Yes. Dr. Elizabeth is saying that in some places in Latin America, you have to have the consent, informed consent from the patient. Okay. I will try to keep it short because I know most of you are already working in this. So to finalize, I think the psychological aspect has to be very well kept in mind. I was impressed when the disability team, the national disability team in Venezuela, they get together and they ask the worker, do you want to continue working? So then when there was a huge disability and the workers say, no, I don't want to return to work, they took that in consideration to make the final decision. And sometimes the patient wants to be classified disabled because he hates that job, but then he finds another job that he likes. That's a reality. So the psychological aspect plays a huge role. So to keep in mind transparency in the system, consultation, compassion, and respect their opinions, assume that the injury is genuine, and to prove it otherwise. There are so many jokes now on social media, like somebody fakely fall down from stairs and claim that it was in the workplace. But at the beginning, our first thought is that we have to think that the injury was genuine work related. Our job is in the return to work process is building a safety culture. You can find me on everywhere. I am even on TikTok, but I don't do any dances. But I know somebody who does. Thank you very much. Peace upon you. This is our Islamic greeting. And to have some fun in this training, yes, I wanted to teach you some Arabic words. So I am coming from Egypt, and I am Egyptian occupational associate professor in occupational medicine. And currently I am a consultant in occupational medicine in Saudi Arabia. So in Egypt or Saudi Arabia, when we say welcome, we say ahlan wa sahlan. You can repeat after me, ahlan, ahlan wa sahlan. So this is mean welcome, ahlan wa sahlan. In Egypt and Saudi Arabia, we use our hands a lot. So when asked from me favor or something to do, I say from my eyes, min ayouni. When I say from, okay, I will make it for you. I say from my eyes, min ayouni. And when I show respect to someone, I say on my head, ala rasi. So just to keep one word, ahlan wa sahlan. This mean welcome. I saw someone laughing there. He is Arabic, I think. Okay. There's no conflict of interest related to today's presentation. I will keep it short like Hamed said. So we have five stages, importance of incubation and fitness program. It is a large debate. Is it important to have the pre-employment or not? Is this beneficial for the employers, employee, co-workers, organization, governmental? And in this paper published in our Journal of Incubation and Environmental Medicine, they state that there is significant difference between the first year cost for integrated benefit among applicant who went through the post-office employment or examination training, examinations. And they related to the medical, drug, worker compensation, short-term disability, and also preventable motor vehicle accidents. So it is very important for us to have this. What about Egypt and Saudi Arabia in this era? In the law of employment and law of work in Egypt, we have to medically examine the worker before joining the work to ascertain his safety and health fitness pursuant to the type of the work to be assigned to him. So no single work, formal work, or worker or employee have his job except he pass the pre-employment examination by law. Also in the Saudi Arabia, we have in the law of working also, and they now change the name to Human Resources, Ministry of Human Resources. An employer shall assign one or more physician to provide at least once a year a comprehensive medical examination for his workers who are exposed to any of the occupational disease listed in the schedule of occupational disease. So it is mandated by the law to have pre-employment and annual occupation examination also. What about the occupational health physician role in this mandation? He designing the pre-employment assessment, and I will show you now one of our case study that we have in Saudi Arabia about this one. Pre-placement assessment by questionnaire in clinic pre-placement medical assessment, issuing the pre-employment fitness for duty certificate and also the return to work medical assessment. We have a best practice in Saudi Arabia. We are located in Yambou City. Yambou City is a small city, industrial city, that have a large number of factories like Aramco, Sabic, a lot of Sadara, a lot of big company, big company name. We have about 80,000 workers sitting in this city. So we established this center, the occupational health care center, the center entirely only for pre-employment and annual occupation examination. We didn't see patient in this center. And in this center, you can take appointment with one desk here for opening the file, opening the medical file, making the contract, also making the invoice, everything in one stop. We have the vital science shop here. We have the clinic of the doctors in the same sitting. You can finish the pre-employment examination and the annual occupation examination only with 30 minutes. You have the decision. Here we have the spirometry, the ultrasound if you want. We have the lab in the same building. We have the x-ray machines. Also, the etiometry booth and the etiometrist. The same time, the spirometry and the ECG. Within 30 minutes, you finish your tour to do the pre-employment and annual occupation examination. And we issue the report with five working days. We have a lot of training programs all over the company that we make awareness about the importance of the pre-employment and the annual occupation examination and what stands for the workers and for the companies also. And this is our census. We have in the three years more than 11,000 employees for the pre-employment and the annual occupation examination. Lastly, and this is the most important point, that Saudi Arabia now in the top notch of the technology. We will see now the World Bank. And they, from two years, they are transferred from the agriculture and the fishing. They're starting in the oil and the gas. And they have very big companies like Aramco, Sadara. And also, they have the general administration. And they establish a council for, national council for occupational health and safety. This is like OSHA here in USA. And this one has a very good program with key institutions of the national system. And it is providing occupational health services. They make integration for all the services, employment injury schemes, National Research Institute, National Tribate Advisory Board, labor inspections, and the government authority. They make a liaison in programs. And they have a new regulations and legislations about the pre-employment and your commission examination. Also, they have a very good qualification system for all the workers in this new system. And they have this initiative for the pre-employment, periodic assessment, and end of the service examination. This is a new program starting from 2022. And here is the source from the World Bank that Saudi Arabia is one of the top notch compared by other world in the GovTech maturity index. So everything now in Saudi Arabia is digitalized. The pre-employment, the annual commission examinations, everything on the system and the platform. And it's a very good notch. And we have the honor to Professor Yohamma, Dr. Addy, Warren Silverman, Richard Herron come to our conference last May, the first week of May. And they see the application of artificial intelligence also in our system and our initiatives. Great, thanks. Now we can move to Indonesia. And we need to also have some words from Indonesia like welcome, ahlan wa sahlan. You get that? Okay, okay, good. Okay. Thank you. I would like to share some experience from Indonesia. Also the fitness to work and return to work implementation, best practice in Indonesia. And I work now in the government as a regulator of occupational health implementation for all and guests throughout Indonesia. I have no conflict of interest to disclosure. As a background, we know that this is the number of the fatalities, illness, and work-related incident statistic based on ILO report. And with this background, we should prevent this happen. So what should we do? That we will make fit to work, one of our occupational health implementation is fit to work implementation by definition means that that person is in state physically, mentally, and emotionally, which enables him or her to perform assigned tasks competently in a manner which does not compromise or threaten his and others. So not only ourselves, but also our other workers. And just for you to know, we are in the equator, halfway of this place, in the other side of this place. So my mother may be already sleeping because over there is only 1030 AM. PM, sorry. And then, so this is, we consist of 17,000 islands. Most of people stayed in the city in Java, in Java Island. Java Island, we have 280 million population. Half of them stayed in this small island. And the rest are spreading in this island. And half, 70% of them are workers. Regarding fit to work program, all companies or the workplace are mandatory to have the health management system. And regulated, it's also regulated by the government, save in Egypt, we are mandatory to have once a year medical checkup. And we also already have a collaboration amongst the government, professional related ministry, health department, manpower department, industrial department, what kind of examination that should be based on a risk-based fit to work program. So it's already in the regulation. And all the companies should meet that regulation. For sure that there are challenges, how about informal workers? The government has the responsibility to take care of informal workers. And we have also a big challenge about the implementation, about the consequences of not meeting the regulation. We will talk about it later. And we have a government regulation. Our approach in occupational health is based on the basic occupational system, prevention, promotion, and then treatment of medical emergency response. And fit to work is part of the prevention program to make sure that every worker are fit to work. And then the manpower also, the manpower ministry regulation also already mentioned about the risk-based fit to work. And we also just released the President's Decree on Occupational Illness Management, the newest one last two years. And then we also have the Association of Occupational Medicine Association that developed how to do the fit to work assessment for all medical personnel. And also develop some books regarding the fit to work, also the vaccination to the workers. So it will be, it's developed by the professional group in Indonesia. And the competent medical professional is also already written in the government regulation that the one who can perform fit to work examination is medical doctor with occupational medicine degree. Not only the residency, but also we have the Master of Occupational Medicine. And also we are also allowed to have a medical doctor with additional specific training that is developed by the manpower, the health ministry. So since our occupational medicine specialist is only three, almost 344 million workers, so GP can perform the fit to work assessment with the specific training on how to do the fit to work examination. So about fit to work and return to work standard, this is the one that is developed by the Association of Occupational Medicine. So there are seven steps to do for doing the fit to work and also return to work. So for sure the first, all the medical personnel has to know the description of the work position and the work environment to define, to identify the risk, the hazard that the worker can face. And also what the job demand that the worker have, like physical, motoric work environment, mental organization. Let's say for the supervisor level, if they have the mental issues, for sure he's not fit to be a supervisor. Or emergency situation that I work in oil and gas, for the one who's not ready to save himself out of the emergency situation is not allowed to work in the refinery, something like that. And also the health condition, the comorbidity, about the disability status, the functional capability that Prof. Yoham already said that now we see more on functional rather than disability. And also what safety risk that they have, the tolerance of the work and also the return, and the final, the final of the fit or the return to work assessment. So these seven steps are trained by the Association of Occupational Medicine to perform the fit to work assessment in Indonesia. Here we adopt, in oil and gas itself, we adopt one of the metrics that is developed by international oil and gas producers. So we have a certain group of workers and what specific examination that they have. And we, so let's say like commercial driver, they have to have a medical questionnaire and then the medical examination, and then for sure that aerobic fitness test because they have to have a good cardiovascular function. And also the visual test is part of the, we have the metrics for each position, what assessment of fit to work assessment that they have to do for each position. Also the, let's say the food handler, the office worker, the remote worker, we have the metrics, so fit to work assessment is really specific for each job position. So in Indonesia itself, since our cardiovascular numbers quite high, and I think it's also happened in so many countries, on the top of this, we add more on the cardiovascular risk assessment. So we perform as a basic general examination, we perform the lipid profile, we check on HbA1c, and then all the, about the BMI and all the basic cardiovascular risk, even for the remote, for the remote offshore worker, above 35, we mandatory to perform the treadmill test as a basic screening for going to the remote or offshore in oil and gas. Some, but it cannot be implied to other industry because regarding the financial and the facility, so it's all, so we develop four pillars, the big industry, the middle industry, and then for the basic, that is mandatory by the government. And the fit to work setup in the workplace, so like Prof. Ahmed said, you have your own clinic, I just put the example in the oil and gas, we are not allowed to do the medical checkup itself in our workplace. So we will assign one of the GMA provider outside, and we assess the GMA provider, whether they can perform the fit to work based on our requirement. So there's a standard about the permit of the clinic, and then the medical competency, because like I mentioned before, sometimes the GMA provider only provide the GP without the occupational health background. So we make a score, we make a score of the medical checkup provider to meet our standard, to meet the industrial standard based on the metrics that is displayed before. So this JMA provider will get our referral letter, what assessment that has to be done, and then they will produce the fit-to-work report if the JMA provider or they have, let's say, the occupational health. Saira already said, because we just started at 11, and they said that it will be finished at 12. 12. Yeah. 12. 12. Thank you. So some of the workplace will re-evaluate, because not all the medical checkup provider release the fit-to-work assessment based on what we need. So sometimes we need to have fit-to-work evaluation based on the JMA report from the provider. And this is part of the JMA provider assessment, only that's what we do in oil and gas. And as the last slide that, yes, Indonesia, thank God that the government regulation is there, so it's easier for us to implement the fit-to-work assessment for the workers. And for sure that we are part of the health management system. The communication commitment is also mandatory, and the competent personnel fit-to-work and return-to-work assessment is the training is already there. So far, we are going to the right track to provide all the fit-to-work for all the workers as a mandatory in the regulation. And also the communication collaboration with different functions within workplace, like Prof. Jihama said, within the HR, the payroll, and then also the safety, the operation department is in place to ensure that they know that their workers are fit to do in their workplace. I think that's all. If Prof. Ahmed said, ahlan was ahlan, I want to ask in Indonesia, terima kasih for the thank you. Terima kasih. Terima kasih. Is there any question? Terima kasih. Yes, please. So for the POET testing, is it some sort of, because you had all those different job categories and what the requirements were, is this some sort of national job description for all of those that they have these minimum standards they have to meet, and then you pass or fail them based off of those minimum standards? Okay. On the regulation itself, on the written regulation, it's not, it's a matrix. This matrix is only for oil and gas. This is the example for oil and gas, yes. But for the national regulation, it's only said risk-based fit-to-work assessment. So to make it easier for some industry, they make their own matrix like that. And then they also have the matrix where there is what is fit, what is fit with restriction, and what is unfit. So if, let's say, for the offshore worker, for the hemoglobin, it's a minimum like 10 for women. So if it's below 10, it means it's not fit, something like that. So there's a matrix to define what's the fit and unfit status for the workers. Yes? You're welcome. Hi. My name's Gornia. I practice in London. Okay. I'd like to ask, please, what information is communicated to the employer if the individual is unfit? So for both Saudi Arabia and for Indonesia, what is the consent process, and what happens to that worker? Okay. Thank you. Thank you so much. So maybe I will share my mind first. In Indonesia, so after we evaluate the fit-to-work assessment, and then we release the fit-to-work certificate, and then we will communicate to the supervisors and also to the workers. And then for sure that we will inform that you are having a certain health condition. So we will plan to release the, let's say, temporary unfit certificate. And after that, we will have the return-to-work program until you can be back to work. And then we will, together, to have a return-to-work plan, regular evaluation to the work together with the treating physician. So we as a company doctor, we only just follow up the treatment from the referral specialist. But before all of them, when the workers do the medical check-up, they have to sign the informed consent that the information will be sent to the company, and also only to the company doctors. Thank you. You're welcome. It's the same in Saudi Arabia. We are a governmental center. We're doing the pre-employment and annual incubation examination. We have a very, about four or five pages of the consent about the medical conditions, and we disclose only to the company doctor, not the HR people, not everyone. And also he has a right, the employee himself, to know the condition and how it affect his employment and his workshop. And we always discuss with him in very important discussion that he is not fit for the job. The job is not fit for him. And you make better job rule in another job, but this is not for you. So it is a job to make a consent and disclose it for the medical personnel only, not the HR, not the employer himself. And it will be a top secret, the decision. And we make, we don't say it is not fit for the medical condition. We say, refer it to incubation medical committee. And this committee means that's incubation medicine consultant with the company doctor and with the employee himself. And this is that. And is it mandatory for all companies to have a company doctor? Yes, yes. More than 100, they must contract like, so in the law, it's mandatory to have doctors and they're caring about the health of everyone. Okay. And what about, do you work with third party providers or is it always a company doctor? Yes, that's, all come like that, third party, because there is no certification or there is no opening the clinic inside the factory. So they consulting or they are contracting with the third party. Like Concentra, we have the same companies like that in the Middle East and Saudi Arabia. Okay. Thank you. You're welcome. Thank you. Good afternoon. My name is Marshina Jones from Orlando. You actually answered the question, what I was going to ask, and it was about pre-employment. I know many companies here think it's biased to do pre-employment. How do you get around that? Because I have found in my experience that when there's an injury that comes in a clinic, and I'll ask myself, how did, you know, you should not even be in this position because of your history, but because we're not doing the pre-employment because some places say it's biased. How do we get around that? I love what you said about every year, not only are you doing it, but you're doing it every year. Yes. That's right. That's amazing. It's mandating now. One of the company also said not only every year, but every time you move job, there's another fit for duty, not only the whole examination, but for the certain examination that they need based on their job. Wow. That's amazing. I just wanted to clap and say that is great that you're doing it. Thank you. Thank you for sharing. I would like to build on your comment. In many countries, it's mandatory, the pre-employment, and yes, the reason is like it can be used as an exclusion criteria to employ the worker, but the matter of fact, we have found in many, for example, in Venezuela, you cannot say not fit for duty. You can say fit with limitations. The doctor should write what are the limitations for this worker because while there's a huge law in Venezuela about diversity and inclusion and having a disease or a diagnosis shouldn't be an exclusion criteria for anybody to have a job. That's the beauty in paper. In reality, unfortunately, we know they're using the pre-employment to exclude people. It's really hard. I put the hat of human resources or the hat, for example, if you need somebody who have to do inspections around a dangerous place that is a very limited space, but he has a model disability and he's in a wheelchair, it's very complicated. I think because sometimes not all the jobs are available, it's a unique job position. I think we have to arrive to terms and agree to find the best to include our workers and also adapt it with the needs of the companies and enterprises. Yes, please. Okay. Going back to actual employees and them getting injured and then returning to work on transitional duty, et cetera, our biggest challenge is we have 170 sites across the US. We have a nice return to work program and a nice list of transitional duty tasks the workers can do, but site leaders decide you affect my productivity negatively. I will not allow you to come on site for transitional duty. You must use our nonprofit vendor and go to the thrift shop or the soup kitchen and do your transitional duty there. Do you have those kinds of barriers overseas and how does that work? For us, no. For us, no. Sometimes even we create the job for the one who is, let's say, after the stroke. We create the job for him. Because the mental health is really important. We don't want them to be excluded. But maybe for the manufacturer, manufacturer with a lot of manpower, it's a different story of what my experience is. Even we try to create some work for him, even administrative work, but it's still within the entity. It's the same. For us, the same. Yes. A quick comment. I've learned, I don't know if this has changed in the United States, that for a mother that just had a baby in the U.S., they have like one month of paid permission. And if the replacement, the person who is making her job is better, she will get fired. Is that a reality still in the U.S.? No. Kind of close to it, because I'm a witness to that. I was told that I'd be back in six weeks. And it was threatening for my job, so I'm not in a job right now. But I would like to work for that fear. So yeah, every country, and sometimes every workplace is a world on its own. And they have to comply with the national legislation, but then they have their local, their own policies. So this transition is very complex. It's easier for companies that are more than 100 employees, and they have established service. But for small and medium enterprises, it's a real challenge. For the informal economy, it's an existence. And like a return to work process, they are their own owners. They are their own employees. So it's a very challenging situation for small, medium enterprises and informal economy. Sir, do you want to add something? Just a comment on the whole of the pre-employment. You can't do that in the U.S. A lot of people don't think you can. You can, legally. It's a very small window. Parallels, the concept of doing drug screening. You have to define it. I really suggest you go with an occupational therapist type to define a job. There's a series of rules. The question on what is the important gift. We should get a pass-fail. I don't want to know any of the other information. But if there's a fail, then there's a letter going back saying you didn't pass. You're welcome to come back at whatever time you want to to retry. And you're welcome to come into our factory, tour the jobs, and see if there's an accommodation. It's possible. It's very narrow. The cost is not zero. Well, in my experience, employers I've worked for have gone away from pre-employment testing. Because the latest stat I've heard, I haven't validated, is that 95% of candidates pass pre-employment testing. It's very costly and does little return. So, in my experience, they've gone away from it. Say again? Safety-sensitive jobs. Yeah. Yeah. Because right now, we're engaging the people on the farm with the other people. Exactly. The box-cent failure rate is great. We got down to like one or two percent. And there's an effect also that once that local community knows that you're testing them. Yes. That's a good thing, too. Well, the concept of fitness for duty is to protect the worker, their colleagues, and the workplace. Yes. So, I personally agree with the pre-employment when it's well done ethically. Because, for example, if you don't want your pilot to have sleep apnea and fall asleep. I mean, in some countries, the sleep test is mandatory for drivers. So, I think pre-employment tests, when they're due ethically, and they fit their purpose. To see the qualifications and limitations are really well performed. And I absolutely agree. In the UK, you can't withdraw an offer of work. Unless it's a safety-critical duty. And they do pre-employment to understand whether something called the Equality Act applies. And that means that that person will benefit in adjusting to the workplace. Exactly. But you can't actually withdraw the offer even if somebody has chronic medical conditions. Unless the workplace is safety-critical. Exactly. The way it should be. Thank you. So, the pre-employment is whether a person is safe to practice in that job or that kind of deployment. And sending people out. Well, I'm okay with the office kind of setting. With non-safety-related jobs. But in certain jobs, for example, if you have somebody who has been pulling gloves, pulling pipelines, gas lines, or even trucks. You don't know whether he is a handsome drunk or not. That's something that's dangerous. Complex, yes. Well, if nobody else has any comments or questions, we thank you very much. Thank you very much. Thank you.

Indonesia

Egypt

Saudi Arabia

return-to-work principles

collaborative program

injured workers

individualized plans

ongoing monitoring

workplace culture