The occupational and environmental history and examination.
Environmental and occupational medicine, third edition. Rom WN, ed. Philadelphia, PA: Lippencott-Raven Publishers, 1998 Sep; :31-38
Bernardino Ramazzini (1), the revered Italian physician who encouraged us all to ask our patients about their occupation, recognized the crucial importance of a good occupational and environmental history. Indeed, a brief occupational and environmental history should be a part of every patient's medical chart. Unfortunately, good occupational histories are often missing. In a recent study of a primary care practice in an academic setting, only 24% of 625 charts reviewed included any mention of the patient's occupation; only 2% included information about toxic exposures, duration of present employment, and former occupations (2). There are several contexts in which an occupational and environmental history and examination may be performed. the tow most common are preplacement physicals and periodic medical screening and surveillance examinations. Less common are return-to-work assessments, exit examinations, and evaluations for specific occupational exposures or diseases. To a greater or lesser extent, all include the same basic components: the occupational/environmental history, the medical history and review of systems, and the physical examination. After these components are discussed, the various examination settings are considered separately as there are unique aspects to each.
Physical-examination; Physical-fitness; Occupational-hazards; Occupational-exposure; Medical-examinations; Medical-care
National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, Morgantown, WV 26505
Environmental and occupational medicine, third edition