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Is work making your Is work making your patients ill?patients ill?
Work and diseaseWork and disease
Grant McMillanGrant McMillan
Hon Senior Clinical LecturerHon 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 pointsLearning points
• Range of adverse effects of workRange of adverse effects of work
on individuals in common occupationson individuals in common occupations
• Importance of considering occupation Importance of considering occupation
when seeking a diagnosis or a remedywhen seeking a diagnosis or a remedy
• Readily accessible sources of information Readily accessible sources of information about occupational diseaseabout occupational disease
Categories of work-related Categories of work-related diseasesdiseases
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 pointsLearning points
• Range of adverse effects of workRange of adverse effects of work
on individuals in common on individuals in common occupationsoccupations
• Importance of considering occupation Importance of considering occupation
when seeking a diagnosis or a remedywhen seeking a diagnosis or a remedy
• Readily accessible sources of information Readily accessible sources of information about occupational diseaseabout occupational disease
Work the causeWork the cause
• TannerTanner
• BricklayerBricklayer
• Needle gun operatorNeedle gun operator
• Chrome platerChrome plater
Work the cause Work the cause - tanning animal hides Hazard and effect?
Clue!Clue!Can also be hazard to postal workersCan also be hazard to postal workers
Work the cause Work the cause - tanning animal hides Hazard - Bacillus Anthracis
Work the cause Work the cause - tanning animal hides Effect - cutaneous anthrax.
There is also a pulmonary form.
Work the cause Work the cause - bricklaying- Hazard and effect?
Work the cause Work the cause - bricklayingClue – spot the difference
BricklayingBricklaying Hazard Hazard – cement is hygroscopic
Effect is excess dryness – usually short-lived if treated
Hazard Hazard – hexavalent chromium in cement Effect - allergic/contact dermatitis
- sensitised for life
Work the cause Work the cause – needle gun operatorHazards and effects?
Hazards are high sound pressure levels and high levels of vibration.
Work the cause Work the cause – needle gunEffects – noise-induced hearing loss and Hand Arm Vibration Syndrome
Work the cause Work the cause – chrome plating - Hazard and effects?
Work the cause Work the cause – chrome plating Hazard is hexavalent chromium in mists
Work the cause Work the cause – chrome plating Effects – sensitisation, irritation, cutaneous
ulcers, perforation of nasal septum (and lung cancer)
Work the causeWork the cause of what disorders of the knee? of what disorders of the knee?
Categories of work-related Categories of work-related diseasesdiseases
II Work the causeWork the cause
II Work a causal factor in diseases of common occurrence
III III Work aggravating an established Work aggravating an established diseasedisease
IV Work offering ready access to potential dangers
Work a causal factor in diseases of Work a causal factor in diseases of common occurrencecommon occurrence
• ShipwrightShipwright
• TypistTypist
• Road construction workersRoad construction workers
• Soldier, sailor and airmanSoldier, sailor and airman
• Teachers, Prison Service, PoliceTeachers, Prison Service, Police
• Florist, hairdresserFlorist, hairdresser
• Vehicle sprayers, bakersVehicle sprayers, bakers
• FishmongerFishmonger
Categories of work-related Categories of work-related diseasesdiseases
II Work the causeWork the cause
II Work a causal factor in diseases of common occurrence
III III Work aggravating an established Work aggravating an established diseasedisease
IV Work offering ready access to potential dangers
Welding fume and chronic obstructive pulmonary disease
Categories of work-related Categories of work-related diseasesdiseases
II Work the causeWork the cause
II Work a causal factor in diseases of common occurrence
III Work aggravating an established disease
IV IV Work offering ready access to Work offering ready access to potential dangerspotential dangers
Learning pointsLearning points
• Range of adverse effects of workRange of adverse effects of work
on individuals in common occupationson individuals in common occupations
• Importance of considering occupation Importance of considering occupation
when seeking a diagnosis or a remedywhen seeking a diagnosis or a remedy
• Readily accessible sources of Readily accessible sources of information about occupational information about occupational diseasedisease
Readily accessible sources of Readily accessible sources of information about occupational diseaseinformation about occupational disease
First port of call :First port of call :
Health and Safety Executive: Health and Safety Executive: www.hse.gov.uk
Government policy on health at work: Government policy on health at work: www.dh.gov.uk
Is work making your Is work making your patients ill?patients ill?
Part 2 Work and diseasePart 2 Work and disease
Grant McMillanGrant McMillan
Hon Senior Clinical LecturerHon Senior Clinical Lecturer
Thank you for your attentionThank you for your attention