Occupational illnesses Notes Social Pharmacy
An occupational disorder is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition
Occupational asthma
Occupational chronic obstructive pulmonary disease COPD
Occupational contact dermatitis
Occupational musculoskeletal disorders
Occupational asthma
Occupational asthma is the most prevalent occupational lung disorder in industrialized countries and presents with classic asthma symptoms (cough, difficulty breathing, chest tightness, wheezing).
Types:
Irritant-induced asthma (cough, shortness of breath, wheezing typically within 24 hours of exposure)
Chlorine: Papermill workers
High-level-irritant dust: Construction workers, rescue workers
Smoke: Firefighters and other rescue workers
Sensitizer-induced asthma*: high-molecular-weight agents (respiratory symptoms often accompanied by rhinitis; a latency period of two years may be observed)
Animals: Farmers, laboratory workers
Bioaerosols: Health care workers, researchers
Drugs: Health care workers, researchers
Enzymes: Bakers, house cleaners
Latex: Health care workers, laboratory workers
Plants: Farmers, bakers, field workers
Seafood: Seafood processing
Sensitizer-induced asthma*: low-molecular-weight agents (symptoms similar to those caused by high-molecular-weight agents, but there may be a delayed response)
Acid anhydrides: Epoxy resin workers
Diisocyanates: Plastic industry, insulation workers, spray painters
Isocyanates: Painters
Metals: Metal refinery, metal alloy production, electroplating, welding
Occupational chronic obstructive pulmonary disease COPD
The occupational chronic obstructive pulmonary disease has been linked with exposure to nonspecific vapours, gases, dust, fumes, and cigarette smoke.
The diagnosis of occupational COPD varies, but it is generally made using spirometry, the Global Initiative for Chronic Obstructive Lung Disease criteria used for non-occupational COPD (forced expiratory volume in one second/forced vital capacity ratio of less than 70%), and appropriate occupational history. Spirometry should be conducted with precision to avoid underdiagnosis that could delay diagnosis and management
Clear guidelines for the treatment of occupational COPD are currently lacking Physicians should work with patients and employers to eliminate respiratory exposures. Primary prevention strategies include identification of workplace hazards and use of personal protective equipment, and secondary prevention focuses on medical surveillance with the use of symptom questionnaires
Occupational contact dermatitis
Occupational contact dermatitis is the most common dermal exposure. It can be caused by exposure to a variety of agents, including primary irritants or sensitizers, physical agents, mechanical trauma, and biologic agents.
Occupational musculoskeletal disorders include many common repetitive injuries such as carpal tunnel syndrome and medial or lateral epicondylitis. Treatment of occupational disorders is generally the same as for nonoccupational disorders.
Occupational Skin Disorders and Associated Occupations
Acne: Artisans, factory workers, asphalt workers, carpenters, construction workers, paint manufacturing workers
Allergic contact dermatitis: Agricultural workers, cement workers, forestry workers, health care workers, laboratory workers
Burns: Asphalt workers, carbonated drink production, construction workers, farmers, food service industry, pesticide application workers
Folliculitis: Engineering industry workers, mechanics, oil field/refinery workers, roadway workers, sheep shearers
Irritant contact dermatitis: Auto workers, hairdressers, health care workers, paint industry workers, printers
Mechanical injury: Auto workers, construction workers, metal industry, wood industry
Skin cancer: Carbonated drink production, chimney sweeps, coal/tar workers, farmers, metal industry, mining, outdoor occupations, printing industry, roadway workers, roofing
Skin infections: Agricultural workers, food service industry, health care workers, livestock industry, meat workers
Diagnosis
Occupational contact dermatitis can be divided into irritant and allergic types. Irritant contact dermatitis is inflammation due to phototoxic reactions or skin contact with a chemical agent such as acids, bases, oxidizing or reducing agents, water, detergents, and cleaning agents
Occupational musculoskeletal disorders
Occupational musculoskeletal disorders are injuries or disorders of the muscles, tendons, joints, cartilage, and nerves that are caused or exacerbated by sudden exertion or prolonged exposure to physical factors such as repetitive movement, force, vibration, or awkward positions. Common upper-limb disorders include shoulder disorders, lateral epicondylitis, wrist tendinitis, and carpal tunnel syndrome, in addition to nonspecific strains, sprains, muscle tears, back pain, and hernias. Approximately one-half of occupational musculoskeletal disorders occur in those working in the manufacturing and services industries.35 According to 2011 data, musculoskeletal disorders accounted for 33% of all occupational injuries and illnesses.36 The true prevalence of occupational musculoskeletal disorders is difficult to determine because studies use different definitions.37 Risk is measured based on level of hand activity and forceful exertion, awkward positions, and hand-transmitted vibration.
Family physicians should inquire about routine heavy lifting, daily exposure to vibrations, routine overhead work, and repetitive forceful tasks. Workers at risk of occupational musculoskeletal disorders should be encouraged to engage in physical activity and maintain a healthy weight to reduce disease progression. Workplace adaption is critical for prevention and treatment of occupational musculoskeletal disorders. Ideally, the hazard should be removed. Engineering controls should alter factors of applied force, fixed body position, and pace of work. Administrative controls can protect workers through job rotation, forced breaks, and alteration of work pace. A systematic review of workplace-based interventions for the prevention of upper-extremity musculoskeletal disorders showed a positive effect of resistance exercise (dumbbell or kettlebell exercises).
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