3.5.3 Occupational History

Question 1

When taking an Occupational and Environmental history, you essentially taking an exposure history. What are some of the areas an exposure could happen?

Answer 1

At a patients occupation, in their community, in their home, or during personal hobbies/practices

Question 2

What are some of the basic information you should always get in regards to brief occupational history?

Answer 2

Current occupation
Any known risks
Are there any exposure? - If so how do you protect yourself

Question 3

What are some of reasons to take an occupational history?

Answer 3

Is there an association of the disease to occupation, or can the illness alter their actions in their job.

Question 4

What information would you be looking for when doing a diagnostic occupational history?

Answer 4

You are looking for a relationship of any kind between an exposure and a disease. Asking questions like does your work exacerbate this condition?

Question 5

When doing a screening history what are you looking?

Answer 5

This is in the context of surveillance. Patient at risk is followed for early detection, and providing counseling to reduce exposure

Question 6

What is a comprehensive occupation history?

Answer 6

Get the details on every job and every detail.

Question 7

When would be a good time to consider taking a comprehensive occupational history?

Answer 7

If the CC has a temporal relation to time spent at work. If the job is considered “risky”. If there is lab/imaging that suggest some exposure. Also if a disease presents at a younger age than would be normal for it to appear.

Question 8

What are the three sections of the comprehensive occupational history?

Answer 8

Occupational profile
Exposure inventory
Environmental history

Question 9

What is the occupational profile?

Answer 9

Inventory of occupational experience from which exposure to hazards and the degree of risk can be reconstructed

Question 10

What is occupation exposure history?

Answer 10

Patient recalls specific exposures of medical significance. Used to fully characterized the circumstances of an exposure

Question 11

What is an environmental (home) history?

Answer 11

Intended to identify certain important exposures in the home.

Question 12

What are some good questions to ask when dealing taking a comprehensive occ history?

Answer 12

Is you condition better or worse when you go on vacation or have a weekend?
How is you ventilation system?
Do you actually wear your PPE?
Do you recall any specific events that may have occurred?

Question 13

What are some types of exposures in the work place?

Answer 13

Chemical, physical, biologic, or psychological

Question 14

When figuring out the exposure what is important to assess?

Answer 14

The dose the patient may have received?

How much exposure, duration, and frequency

Question 15

What is a sentinel health event?

Answer 15

A preventable disease or disability whose occurrence serves as a warning signal that the quality of preventative actions should be improved

Question 16

What is an inherent SHE(O)?

Answer 16

Disease or condition, which, by their inherent nature, are necessarily occupationally related

Question 17

What is a non-inherent SHE(O)?

Answer 17

Disease such as lung cancer or leukemia which may or may not have been occupationally related, but has clearly been linked to work exposures

Question 18

What are the three ways to control workplace exposures?

Answer 18

Engineering - take it out
Administration - RULES!
PPE

Question 19

What is OSHA?

Answer 19

Occupational Safety and Health Act of 1970 - Attempt to prevent
Sets and enforces protective workplace safety and health standards. Provides training and info to employers and workers.
It is prescriptive in nature. Looks to prevent on-the-job events by emphasizing PPE and other items

Question 20

What is MSDS?

Answer 20

Material safety data sheet. All chemicals that are harmful need to have this sheet. Have little info on them, but can show active ingredients.

Question 21

What is NIOSH?

Answer 21

The National Institute for Occupational Safety and Health. These people do the research and make recommendations on how to increase work place safety.

Question 22

What is the EPA?

Answer 22

Environmental Protection Agency. These people are the enforcers of rules and regulations.

Question 23

What is ATSDR?

Answer 23

Agency for Toxic Substances and Disease Registry. They advise the EPA on the health aspects of hazardous waste sites or spills.

Question 24

How to investigate a disease outbreak?

Answer 24

Confirm diagnosis. Then find other unrecognized case. Create a plot line and determine if there is a dose-relationship.