Occupational History and Examination H.R.Sarreshtahdar, MD Occupational Medicine Specialist.
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Transcript of Occupational History and Examination H.R.Sarreshtahdar, MD Occupational Medicine Specialist.
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?