Occupational History Occupational History and Examinationand Examination

H.R.Sarreshtahdar, H.R.Sarreshtahdar, MDMD

Occupational Medicine Occupational Medicine SpecialistSpecialist

Occupational history Most important tool for the diagnosis

of occupational illness

Symptoms

Exposure

Occupational history Problems:

Time constraints for workers and physicians

Enormous range of known and potential toxic exposures

Important issues: All jobs held and approximate date

of employment Job title is not sufficient Significant changes in job duties Second job

Occupational history Exposure history

Have you ever worked with or been exposed to any of the following substances?

Environmental historyWater source, heating source, pets, proximity to industries, hobbies

Health in Relation To Work

Relationship between symptoms and

time of work shifts or specific

exposures.

Similar complaints among coworkers.

Compensation

Patient Management

The diagnostic period

Formulation of treatment plans

Communication

Follow up

Types of examinations Pre-placement examinations Medical screening and surveillance

examinations Return to work assessment Exit examinations Evaluation for specific occupational

exposures or diseases Fitness for work assessment

Pre-placement examinations

Most common and least specific. Assess a candidate’s suitability for a job. Need detailed description of the essential

functions of the job. Do not easily exclude a worker from a job. Exclusion of the worker if he can not

perform only essential functions of the job.

Surveillance examinations

(Periodic) Screening tests are tools for secondary

prevention In occupational medicine may be a tool

for primary prevention Target-organ or substance-specific More focused than pre-placement

examination Detect early disease Medical screening is not a substitute for

hazard control

Return to work examinations

Assess individuals before returning to work after a period of absence from: Occupational causes Non-occupational causes

Assess fitness for work Need detailed information about job

requirements An interaction between physician, industrial

hygienist, ergonomist, and engineer to safely return the worker to the work.

Exit examinations Structure and content similar to

periodic examinations Target-organ or substance specific The least common occupational

examinations Shows any adverse occupational

health effects before leaving the work

Any question?