Is work making your patients ill Work and

Is work making your patients ill? Work and disease Grant Mc. Millan Hon Senior Clinical Lecturer Institute of Occupational and Environmental Health University of Birmingham Number 8 of a series of lectures and tutorials for medical undergraduates

Learning points • Range of adverse effects of work on individuals in common occupations • Importance of considering occupation when seeking a diagnosis or a remedy • Readily accessible sources of information about occupational disease

Categories of work-related diseases I Work the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

Learning points • Range of adverse effects of work on individuals in common occupations • Importance of considering occupation when seeking a diagnosis or a remedy • Readily accessible sources of information about occupational disease

Work the cause • Tanner • Bricklayer • Needle gun operator • Chrome plater

Work the cause - tanning animal hides Hazard and effect?

Clue! Can also be hazard to postal workers

Work the cause - tanning animal hides Hazard - Bacillus Anthracis

Work the cause - tanning animal hides Effect - cutaneous anthrax. There is also a pulmonary form.

Work the cause - bricklaying - Hazard and effect?

Work the cause - bricklaying Clue – spot the difference

Bricklaying Hazard – cement is hygroscopic Effect is excess dryness – usually short-lived if treated

Hazard – hexavalent chromium in cement Effect - allergic/contact dermatitis - sensitised for life

Work the cause – needle gun operator Hazards and effects?

Hazards are high sound pressure levels and high levels of vibration.

Work the cause – needle gun Effects – noise-induced hearing loss and Hand Arm Vibration Syndrome

Work the cause – chrome plating - Hazard and effects?

Work the cause – chrome plating Hazard is hexavalent chromium in mists

Work the cause – chrome plating Effects – sensitisation, irritation, cutaneous ulcers, perforation of nasal septum (and lung cancer)

Work the cause of what disorders of the knee?

Categories of work-related diseases I Work the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

Work a causal factor in diseases of common occurrence • • Shipwright Typist Road construction workers Soldier, sailor and airman Teachers, Prison Service, Police Florist, hairdresser Vehicle sprayers, bakers Fishmonger

Categories of work-related diseases I Work the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

Welding fume and chronic obstructive pulmonary disease

Categories of work-related diseases I Work the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

Learning points • Range of adverse effects of work on individuals in common occupations • Importance of considering occupation when seeking a diagnosis or a remedy • Readily accessible sources of information about occupational disease

Readily accessible sources of information about occupational disease First port of call : Health and Safety Executive: www. hse. gov. uk Government policy on health at work: www. dh. gov. uk

Is work making your patients ill? Part 2 Work and disease Grant Mc. Millan Hon Senior Clinical Lecturer Thank you for your attention