3.5.3 Occupational History Flashcards
When taking an Occupational and Environmental history, you essentially taking an exposure history. What are some of the areas an exposure could happen?
At a patients occupation, in their community, in their home, or during personal hobbies/practices
What are some of the basic information you should always get in regards to brief occupational history?
Current occupation
Any known risks
Are there any exposure? - If so how do you protect yourself
What are some of reasons to take an occupational history?
Is there an association of the disease to occupation, or can the illness alter their actions in their job.
What information would you be looking for when doing a diagnostic occupational history?
You are looking for a relationship of any kind between an exposure and a disease. Asking questions like does your work exacerbate this condition?
When doing a screening history what are you looking?
This is in the context of surveillance. Patient at risk is followed for early detection, and providing counseling to reduce exposure
What is a comprehensive occupation history?
Get the details on every job and every detail.
When would be a good time to consider taking a comprehensive occupational history?
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.
What are the three sections of the comprehensive occupational history?
Occupational profile
Exposure inventory
Environmental history
What is the occupational profile?
Inventory of occupational experience from which exposure to hazards and the degree of risk can be reconstructed
What is occupation exposure history?
Patient recalls specific exposures of medical significance. Used to fully characterized the circumstances of an exposure
What is an environmental (home) history?
Intended to identify certain important exposures in the home.
What are some good questions to ask when dealing taking a comprehensive occ history?
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?
What are some types of exposures in the work place?
Chemical, physical, biologic, or psychological
When figuring out the exposure what is important to assess?
The dose the patient may have received?
How much exposure, duration, and frequency
What is a sentinel health event?
A preventable disease or disability whose occurrence serves as a warning signal that the quality of preventative actions should be improved
What is an inherent SHE(O)?
Disease or condition, which, by their inherent nature, are necessarily occupationally related
What is a non-inherent SHE(O)?
Disease such as lung cancer or leukemia which may or may not have been occupationally related, but has clearly been linked to work exposures
What are the three ways to control workplace exposures?
Engineering - take it out
Administration - RULES!
PPE
What is OSHA?
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
What is MSDS?
Material safety data sheet. All chemicals that are harmful need to have this sheet. Have little info on them, but can show active ingredients.
What is NIOSH?
The National Institute for Occupational Safety and Health. These people do the research and make recommendations on how to increase work place safety.
What is the EPA?
Environmental Protection Agency. These people are the enforcers of rules and regulations.
What is ATSDR?
Agency for Toxic Substances and Disease Registry. They advise the EPA on the health aspects of hazardous waste sites or spills.
How to investigate a disease outbreak?
Confirm diagnosis. Then find other unrecognized case. Create a plot line and determine if there is a dose-relationship.
