Skip to main content
Top
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Debate

The Primary Care Practitioner and the diagnosis of occupational diseases

Authors: Luca Cegolon, John H Lange, Giuseppe Mastrangelo

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

Rather than a clinical diagnosis, in occupational medicine the critical point is the etiological diagnosis. The first is useful for the therapy, the latter for preventive, epidemiological, regulatory, and insurance measures.

Discussion

As with causality criteria which are employed in population studies, the answering of four easy questions allows a Primary Care Practitioner to establish a causal link between the work activities and a potential disease that a specific patient may present.
After determining the clinical diagnosis and the actual pathology of an occupational disease, the identity, duration, and intensity of the exposure have to be detected for establishing a close-causal effect. The judgment on the occupational origin of the disease requires an integrated approach using multiple sources of information, and goes beyond the clinical diagnosis. This may require consultation with a specialist in occupational medicine.

Summary

It is important that the Primary Care Practitioner takes an accurate medical history since this may be the only chance a patient has to have their occupational disease recognised and properly detected/identified. Proper identification of the causative nature of such diseases is important for establishing preventive measures in eliminating and controlling future cases against exposure, epidemiological reporting and studies (particularly in identifying the rates of disease), regulatory reporting requirements and insurance compensation.
Literature
2.
go back to reference Politi BJ, Arena VC, Schwerha J, Sussman N: Occupational Medical History Taking: How Are Today's Physicians Doing? A Cross-Sectional Investigation of the Frequency of Occupational History Taking by Physicians in a Major U.S. Teaching Center. Journal of Occupational and Environmental Medicine. 2004, 46: 550-555. 10.1097/01.jom.0000128153.79025.e4.CrossRefPubMed Politi BJ, Arena VC, Schwerha J, Sussman N: Occupational Medical History Taking: How Are Today's Physicians Doing? A Cross-Sectional Investigation of the Frequency of Occupational History Taking by Physicians in a Major U.S. Teaching Center. Journal of Occupational and Environmental Medicine. 2004, 46: 550-555. 10.1097/01.jom.0000128153.79025.e4.CrossRefPubMed
3.
go back to reference Newman LS: Occupational Illness. New England Journal of Medicine. 1995, 333: 1126-1134. 10.1056/NEJM199510263331707.CrossRef Newman LS: Occupational Illness. New England Journal of Medicine. 1995, 333: 1126-1134. 10.1056/NEJM199510263331707.CrossRef
4.
go back to reference Lee J, Liem LP, Koh d: Occupational health in general practice in an industrial area of Singapore. Occupational Medicine. 2001, 51: 312-317. 10.1093/occmed/51.5.312.CrossRefPubMed Lee J, Liem LP, Koh d: Occupational health in general practice in an industrial area of Singapore. Occupational Medicine. 2001, 51: 312-317. 10.1093/occmed/51.5.312.CrossRefPubMed
5.
go back to reference Hill AB: The environment and disease: association or causation?. Proc R Med Soc. 1965, 58: 295-300. Hill AB: The environment and disease: association or causation?. Proc R Med Soc. 1965, 58: 295-300.
8.
go back to reference Kivimaki M, Ferrie JE, Hagberg J, Head J, Westerlund H, Vahtera J, Alexanderson K: Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population. Journal of Epidemiology and Community Health. 2007, 61: 915-20. 10.1136/jech.2006.050955.CrossRefPubMedPubMedCentral Kivimaki M, Ferrie JE, Hagberg J, Head J, Westerlund H, Vahtera J, Alexanderson K: Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population. Journal of Epidemiology and Community Health. 2007, 61: 915-20. 10.1136/jech.2006.050955.CrossRefPubMedPubMedCentral
9.
go back to reference Boersma K, Linton SJ: Screening to identify patients at risk: profiles of psychological risk factors for early intervention. Clin J Pain. 2005, 21: 38-43. 10.1097/00002508-200501000-00005.CrossRefPubMed Boersma K, Linton SJ: Screening to identify patients at risk: profiles of psychological risk factors for early intervention. Clin J Pain. 2005, 21: 38-43. 10.1097/00002508-200501000-00005.CrossRefPubMed
10.
go back to reference Vandenplas O, Ghezzo H, Munoz X, Moscato G, Perfetti L, Lemiere C, Labrecque M, L'Archeveque J, Malo JL: What are the questionnaire items most useful in identifying subjects with occupational asthma?. European Respiratory Journal. 2005, 26: 1056-63. 10.1183/09031936.05.00024705.CrossRefPubMed Vandenplas O, Ghezzo H, Munoz X, Moscato G, Perfetti L, Lemiere C, Labrecque M, L'Archeveque J, Malo JL: What are the questionnaire items most useful in identifying subjects with occupational asthma?. European Respiratory Journal. 2005, 26: 1056-63. 10.1183/09031936.05.00024705.CrossRefPubMed
11.
go back to reference Russell G, Brown JB, Stewart M: Managing injured workers: family practice experiences. Canadian Family Physician. 2005, 51: 78-79.PubMedPubMedCentral Russell G, Brown JB, Stewart M: Managing injured workers: family practice experiences. Canadian Family Physician. 2005, 51: 78-79.PubMedPubMedCentral
15.
go back to reference Wolters Kluwer/Lippincott Williams & Wilkins, 2007, Hathaway GJ, Proctor NH, Hughes JP, Fischman ML: Proctor and Hughes' Chemical hazards of the workplace. 1991, Van Nostrand Reinhold, New York Wolters Kluwer/Lippincott Williams & Wilkins, 2007, Hathaway GJ, Proctor NH, Hughes JP, Fischman ML: Proctor and Hughes' Chemical hazards of the workplace. 1991, Van Nostrand Reinhold, New York
16.
go back to reference Klaassen CD: Casarett and Doull's Toxicology: The Basic Science of Poisons. 2008, McGraw-Hill Publishers, New York, NY, 7 Klaassen CD: Casarett and Doull's Toxicology: The Basic Science of Poisons. 2008, McGraw-Hill Publishers, New York, NY, 7
17.
go back to reference Rom WN, Markowitz S: Environmental and occupational medicine. 2007, Wolters Kluwer/Lippincott Williams and Sons, Philadelphia, 4 Rom WN, Markowitz S: Environmental and occupational medicine. 2007, Wolters Kluwer/Lippincott Williams and Sons, Philadelphia, 4
18.
go back to reference Mastrangelo G, Scoizzato L, Ballarin MN, Bellini E, Bizzotto R, Zannol F, Gioffre F, Gobbi M, Tessadri G, Marchioni L, Valentini F, Marangi G, Lange JH: Smoking habits, exposure to asbestos, asbestosis and pleural plaques in 772 past asbestos workers examined by computed tomography. American Journal of Industrial Medicine. 2009, 52: 596-602. 10.1002/ajim.20713.CrossRefPubMed Mastrangelo G, Scoizzato L, Ballarin MN, Bellini E, Bizzotto R, Zannol F, Gioffre F, Gobbi M, Tessadri G, Marchioni L, Valentini F, Marangi G, Lange JH: Smoking habits, exposure to asbestos, asbestosis and pleural plaques in 772 past asbestos workers examined by computed tomography. American Journal of Industrial Medicine. 2009, 52: 596-602. 10.1002/ajim.20713.CrossRefPubMed
19.
go back to reference LaDou J: Current Occupational and Environmental Medicine . 2008, McGraw-Hill Publishers, New York, NY, 4 LaDou J: Current Occupational and Environmental Medicine . 2008, McGraw-Hill Publishers, New York, NY, 4
20.
go back to reference Health and Safety Executive (HSE): COSHH Essentials--easy steps to control chemicals (HSG 193). 1999, Sudbury: HSE Books, ISBN 0 7176 2421 Health and Safety Executive (HSE): COSHH Essentials--easy steps to control chemicals (HSG 193). 1999, Sudbury: HSE Books, ISBN 0 7176 2421
21.
go back to reference Garrod ANI, Rajan Sithamparanadarajah R: Developing COSHH Essentials: Dermal Exposure, Personal Protective Equipment and First Aid. Ann Occup Hyg. 2003, 47: 577-588. 10.1093/annhyg/meg089.CrossRefPubMed Garrod ANI, Rajan Sithamparanadarajah R: Developing COSHH Essentials: Dermal Exposure, Personal Protective Equipment and First Aid. Ann Occup Hyg. 2003, 47: 577-588. 10.1093/annhyg/meg089.CrossRefPubMed
22.
go back to reference Mowe G, Gylseth B, Hartveit F, Skaug V: Occupational asbestos exposure, lung-fiber concentration and latency time in malignant mesothelioma. Scand J Work Environ Health. 1984, 10: 293-298.CrossRefPubMed Mowe G, Gylseth B, Hartveit F, Skaug V: Occupational asbestos exposure, lung-fiber concentration and latency time in malignant mesothelioma. Scand J Work Environ Health. 1984, 10: 293-298.CrossRefPubMed
24.
go back to reference Rosenstock L, Cullen MR: Clinical Occupational Medicine. 1986, WB Saunders Company, Philadelphia PA Rosenstock L, Cullen MR: Clinical Occupational Medicine. 1986, WB Saunders Company, Philadelphia PA
25.
go back to reference Wexler P: The US National Library of Medicine Toxicology and Environmental Health Information Program. Toxicology. 2004, 198: 161-168. 10.1016/j.tox.2004.01.037.CrossRefPubMed Wexler P: The US National Library of Medicine Toxicology and Environmental Health Information Program. Toxicology. 2004, 198: 161-168. 10.1016/j.tox.2004.01.037.CrossRefPubMed
26.
go back to reference Fitzpatrick RB: Haz-Map: information on hazardous chemicals and occupational diseases. Medical Reference Services Quarterly. 2004, 23 (2): 49-56. 10.1300/J115v23n02_05.CrossRefPubMed Fitzpatrick RB: Haz-Map: information on hazardous chemicals and occupational diseases. Medical Reference Services Quarterly. 2004, 23 (2): 49-56. 10.1300/J115v23n02_05.CrossRefPubMed
27.
go back to reference AJ , Anema JR, van der Wal G, van Mechelen W: Work-related disease in general practice: a systematic review. Family Practice. 2005, 22: 197-204. 10.1093/fampra/cmh727.CrossRef AJ , Anema JR, van der Wal G, van Mechelen W: Work-related disease in general practice: a systematic review. Family Practice. 2005, 22: 197-204. 10.1093/fampra/cmh727.CrossRef
28.
go back to reference Driscoll TR, Hendrie AL: Surveillance of work-related disorders in Australia using general practitioner data. Australian New Zeland Journal of Public Health. 2002, 26: 346-51. 10.1111/j.1467-842X.2002.tb00183.x.CrossRef Driscoll TR, Hendrie AL: Surveillance of work-related disorders in Australia using general practitioner data. Australian New Zeland Journal of Public Health. 2002, 26: 346-51. 10.1111/j.1467-842X.2002.tb00183.x.CrossRef
29.
go back to reference Won JU, Dembe AE: Services provided by family physicians for patients with occupational injuries and illnesses. Annals of Family Medicine. 2006, 4: 138-47. 10.1370/afm.515.CrossRefPubMedPubMedCentral Won JU, Dembe AE: Services provided by family physicians for patients with occupational injuries and illnesses. Annals of Family Medicine. 2006, 4: 138-47. 10.1370/afm.515.CrossRefPubMedPubMedCentral
30.
go back to reference Oleinick A, Zaidman B: The law and incomplete database information as confounders in epidemiologic research on occupational injuries and illnesses. American Journal of Industrial Medicine. 2010, 53: 23-36.CrossRefPubMed Oleinick A, Zaidman B: The law and incomplete database information as confounders in epidemiologic research on occupational injuries and illnesses. American Journal of Industrial Medicine. 2010, 53: 23-36.CrossRefPubMed
Metadata
Title
The Primary Care Practitioner and the diagnosis of occupational diseases
Authors
Luca Cegolon
John H Lange
Giuseppe Mastrangelo
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-405

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue