Occupational History Components

Occupational Diseases

• The US experiences over 2 million permanent or temporary disabilities from various causes each year.
• Approximately 400,000 new cases of disabling occupational illnesses occur every year, resulting in 100,000 deaths.
• Globally, 10 million occupational disease cases occur annually, with higher rates in developing countries.
• In the US, an estimated 140 workers die from work-related diseases daily.

Major Categories of Occupational Illness

• Musculoskeletal disorders
• Respiratory disorders
• Neurologic and psychiatric disorders
• Skin disorders
• Reproductive and development disorders
• Cardiovascular disorders
• Hematologic disorders
• Hepatic disorders
• Renal and urinary disorders

Definition and Characteristics

• Occupational diseases are caused by work or work environment.
• Work-related diseases are initiated or facilitated by work.
• Occupational diseases occur among workers exposed to specific hazards.
• They can also affect the general community due to environmental contamination.
• These diseases are caused by the interaction of several extrinsic risk factors.
• Work conditions can aggravate pre-existing diseases, such as hepatic dysfunction, bronchial asthma, and renal disease.

Differences between Occupational Disease and Work-Related Diseases

• Occupational diseases occur mainly among working populations, whereas work-related diseases occur largely in the community.
• Occupational diseases have specific exposure at the workplace, whereas work-related diseases may have multifactorial origins.
• Occupational diseases are notifiable and compensable, whereas work-related diseases may not be.

Costs of Occupational and Work-Related Diseases

• Recognizing occupational disease depends on the occupational history.

The Occupational History

• Description of all jobs held
• Work exposures
• Timing of symptoms
• Epidemiology of symptoms or illness among other workers
• Non-work exposures and other factors
• Job description/nature of job
• Hours of work/shift work
• Types of hazards
• Past occupation
• Other jobs
• Domestic exposures
• Hobbies
• Do other workers have a similar illness?
• Relationship of illness to period away from work

Additional Information in Occupational History

• Smoking/alcohol intake/drugs
• Similar complaints among other workers
• Time relationship between work and symptoms
• Degree of exposure
• Use of protective devices
• Methods of materials handling

Screening for Occupational Disease

• Screening approach:
  • History: questionnaire
  • Physical examination
  • Tests: chest x-ray, pulmonary function test, biologic monitoring, audiometry

Preventing Occupational Disease

• Measures applied to the process or workplace:
  • Substitution of a non-hazardous substance for a hazardous one
  • Installation of engineering controls and devices
  • Job redesign, work organization changes, and work practice alternatives
• Measures primarily directed toward the worker:
  • (not specified in the text)