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Recognizing and preventing occupational and environmental disease and injury.

Sokas-RK; Levy-BS; Wegman-DH; Baron-SL
Occupational and environmental health: recognizing and preventing disease and injury, 6th edition. Levy BS, Wegman DH, Baron SL, Sokas RK, eds. New York: Oxford University Press, 2011 Jan; :23-54
A woman complaining of headache and vomiting visited an urgent care center, where she was diagnosed with a viral syndrome and treated symptomatically. She and her husband and three children returned the following night with the same symptoms and were diagnosed with carbon monoxide poisoning. Inspection of their home revealed a faulty furnace. A woman sought medical attention for a painful right knee. The physician prescribed diet and exercise with no improvement. At a follow-up visit, she announced that her problem had resolved after a co-worker showed her how to pad the knee-operated pedal on her sewing machine at work. Orders for lead-containing chemical products from a factory increased when its competitor went out of business. As production increased, physicians found an increased number of workers with high blood lead levels (BLLs), removed them from work using the Occupational Safety and Health Administration (OSHA) Lead Standard, and returned them to work only after their BLLs declined. Several workers went through this cycle repeatedly. Some workers' children had elevated BLLs on routine testing by their pediatricians. In the same factory, in response to an OSHA inspection, an overhead exhaust hood was installed in the room where workers opened bags of inorganic lead to feed into a hopper to be mixed into a final product. The purpose of the hood was to provide local exhaust ventilation to capture and remove lead dust from the workers' breathing zones. The workers had been using a table to hold the bags before opening them and dumping them: with the new hood, there was no room for the table, and bags were instead placed on and lifted from the floor. The number of back injuries resulting in lost work time increased. In a mining town, occupational health investigations conducted in the 1980s revealed asbestos-related diseases and deaths among workers who mined and processed asbestos-containing vermiculite ore. These workplace deaths were not seen as sentinel health events. Vermiculite waste was not controlled until deaths from mesothelioma were reported in community residents in the 1990s. Recognizing an occupational or environmental illness and injury requires characterizing a specific health outcome, identifying a hazardous exposure, and determining a relationship between exposure and outcome. Once this relationship has been established, interventions can be developed that will interrupt tbe causal pathway, thereby preventing illness and injury-the goal of occupational and environmental health and safety. Since illnesses and injuries may be difficult or impossible to treat or may result in complications, it is best to identify a problem early, when the affected person may be treated effectively and when other people at work and in the community can be protected. The five examples at the start of this chapter demonstrate how occupational or environmental illnesses may fail to be recognized and opportunities for prevention may be missed. These examples highlight common themes, such as the need for better communication and feedback.
Health-hazards; Occupational-hazards; Occupational-exposure; Occupational-diseases; Hazards; Environmental-exposure; Environmental-hazards; Injuries; Diseases; Workplace-monitoring; Surveillance-programs; Occupational-medicine; Industrial-exposures; Industrial-hazards; Preventive-medicine; Physicians
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Levy-BS; Wegman-DH; Baron-SL; Sokas-RK
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NIOSH Division
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Occupational and environmental health: recognizing and preventing disease and injury, 6th edition
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division