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A case for documenting occupational history in the medical record.

Luckhaupt-SE; Calvert-GM
MedscapeCME Pub Health Prev 2010 Jan; :715473
There are many reasons why clinicians should consider and document all patients' occupational histories. At each patient encounter, the healthcare provider can quickly ascertain whether the presenting illness may be related to workplace exposures by asking a few screening questions, as described earlier. Additional useful questions include: 1. Are you currently exposed to chemicals, dusts, metals, radiation, noise, or repetitive work or were you in the past? 2. Have you recently started working with any new materials or started doing any new activities at work? If an occupational disease is suspected, many resources are available to assist the clinician. In addition, the clinician can consider referring the patient to an occupational medicine specialist. The specialist will collect a full occupational history including a detailed assessment of all jobs the patient has ever held, identification of potentially hazardous exposures (e.g., physical, chemical, biological, psychological) at each of those jobs, and evaluation of the relationship between symptoms and work. Clinicians should be aware of state requirements for reporting specific occupational diseases, such as pesticide poisoning and lead poisoning, and any unusual disease clusters, which would include potential occupational clusters. The Council of State and Territorial Epidemiologists provides links to reportable conditions Websites for each state. (Of note, the aforementioned link is optimized for Internet Explorer only.) Clinicians are encouraged to refer to the resources described in this article for the evaluation of individual cases and illness clusters for occupational causes.
Diagnostic-techniques; Occupational-exposure; Occupational-diseases; Occupational-health-services; Worker-health; Surveillance-programs
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MedscapeCME Public Health & Prevention