3. Occupational diseases
• Symptomatology
– Mimic common or general diseases
• Progress
– Unrelenting unless in the very early stage
• Treatment
– Not specific and/or not curative
3
4. Diagnosis of a disease
1. Changes in general well being (Subjective): Medical
history and use of specific questionnaires
(Symptomatology)
2. Changes in physical states and function of body
systems (Objective): Physical examination (Signs)
and laboratory examination
3. Biochemical and morphological changes:
Laboratory analysis
4
5. Diagnosis of an occupational disease
1. Changes in general well being (Subjective):
Medical history and use of specific
questionnaires (Symptomatology)
2. Carefully taken detailed occupational
history
3. Changes in physical states and function of body
systems (Objective): Physical examination (Signs)
and laboratory examination
4. Biochemical and morphological changes:
Laboratory analysis
5
6. Bernardino Ramazzinni, 1713
• …What occupation does he follow?
• …concerned with exciting causes and should be
particularly kept in mind when the patient belongs to
the common people. In medical practice attention is
hardly ever paid to this matter though for effective
treatment, evidence of this sort has the utmost
weight
6
7. Donald Hunter, 1978
‘No doctor can be expected to be familiar with the
details of all occupations and every working
environment, but at least he should take the
opportunity to study those industries which fall
within the area of his practice… there are few
surer and quicker means of gaining a patient’s
confidence than the display of an intelligent
knowledge of his job. Many workers are
intelligent, cooperative and good witness.
Although some may be deaf, disconsolate,
forgetful, obtuse, garrulous, or monosyllabic, the
worker is still the best witness of what happened.’
7
8. Hunter’s advice is to ‘ask
whether any similar illness has
occurred in a fellow workman’
8
9. Present Occupation
Duration, hours of work, shifts, level of
responsibility, unusual job demands
Chemical Agents Dust, fumes, gases and
liquids
Physical Agents High and low temperatures,
noise, radiations, inadequate
lightning
Biological Agents Infected materials
Ergonomic factors Machine design, seating, etc.
Psychological factors Methods of payment, joint
consultation, lines of
communication, work
satisfaction
Any other health risks
9
10. Previous Occupations
PNEUMOCONIOSIS DEATHS IN ‘END OCCUPATIONS’ IN
ENGLAND AND WALES (1970/72) AT AGE 15 -74
Occupation Number of deaths
Warehousemen and storekeepers 28
Stationary engine drivers 23
Clerks 11
Guards and related workers 9
Caretakers 6
Salesmen 4
10
11. Occupational History
• Description of all pertinent jobs – past and
present
• Review of exposure in these jobs
• Timing of symptoms in relation to work
• Similar problems among co-workers
• Non-work factors
11
12. 12
Job description/nature
Hrs.of work/shift
Types of hazards
Past occupations
Other jobs
Domestic exposure
Hobbies
Similar illness in other workers
13. 13
Smoking habits
Similar complaints in others
Time relationship bet. Work & symptoms
Degree of exposure
Use of protective devices
Methods of material handling
