Sentinel pathophysiologic conditions: An adjunct to teaching occupational and environmental disease recogniton and history taking.
Environ Res 1992 Oct; 59(1):93-100
Reasons for the lack of adequate education in the identification of occupational and environmental (O/E) diseases by medical schools and practices were discussed. It was theorized that since many diseases may occur as both O/E or nonO/E diseases the problem in making O/E diagnoses may be due to a lack of competence, confidence, and motivation during the historical evaluation of the exposure by the doctors. The use of Occupational/Environmental Sentinel Health Conditions (SHC) as a guide to assist in the recognition of diseases with occupational and/or environmental etiologies was described. The proposed SHC would contain a list of Occupational Sentinel Health Events similar to one described in 1983; however, the list would include Sentinel Pathophysiologic Conditions (SPC) based upon symptoms or laboratory findings, rather than final diagnoses. A table was presented listing SPCs for environmental and occupational evaluations. The authors suggest the implementation of the use of the proposed conditions early in medical school and describe how this type of thinking can be incorporated into the medical school curriculum.
NIOSH-Publication; NIOSH-Grant; Training; Occupational-medicine; Medical-treatment; Medical-screening; Occupational-diseases; Environmental-exposure; Clinical-diagnosis
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Mount Sinai School of Medicine, New York, New York