Clinical Evaluation of Occupational Disorders
All occupational diseases are preventable. They arise from exposures on the job and can be eliminated. Most of this chapter is devoted to medical evaluation of diseases caused by work. Workers may be exposed to hazardous exposures, such as chemicals or biological pathogens, through inhalation, by touching or ingestion. The medical evaluation may show that the condition is acute, meaning that the onset is sudden and the course of the disease progresses in a relatively short time, or chronic, meaning that the course of the disease, usually including the onset, takes years and often a lifetime. The key element of an evaluation of suspected occupational disease undertaken by a physician, nurse or other health care provider is the occupational history. The physician or other health care provider is generally concerned first with identifying the disease and making the diagnosis and then to establish work-relatedness. The health care provider assesses the worker's fitness to work, by determining if the worker, in the present condition, can do the tasks required by the job safely, at no risk to themselves or to others. If the disorder appears likely to be permanent, the health care provider assesses impairment. Disabilitymalingerers is the gap between what the worker can do and what is necessary to do a job or perform some normal function. Functional impairment may be so severe that the worker is not fit to work at his or her usual job or another job. Health care providers need to be alert to people who fake their symptoms, called malingerers, and people who tend to exaggerate their symptoms because they are anxious or want attention. More common is somatization, when some people who are stressed psychologically or anxious express their feelings through bodily symptoms or temporary impairment.
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