ISSUES IN OCCUPATIONAL AND ENVIRONMENTAL MEDICINE JOSEPH J SCHWERHA MD MPH PROFESSOR OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE DIRECTOR OF THE OCCUPATIONAL AND ENVIRONMENTAL MEDICINE RESIDENCY PROGRAM GRADUATE SCHOOL OF PUBLIC HEALTH UNIVERSITY OF PITTSBURGH Web page of Dr. Joseph J. Schwerha http://www.ceoh.pitt.edu/faculty/schwerha/index.html

ISSUES continued Occupational History World Economy Genomes Epidemiology Workplace Environmental Industrial Hygiene Complete occupational history is critical The world has gotten smaller The only way to stop certain diseases is through genetics The history of disease must be understood Environment – 24 hours/day, 7 days/week for life Measurement of toxic substance concentrations is important

ISSUES continued Safety Economics Employee Assistance Program Managed Care Toxicology Workers’ Compensation Government Regulations Safety everywhere Economic factors affect direct control Progress cannot be made without funding Government regulations help and hinder good working conditions Workers’ compensation is no fault

ISSUES Continued Disability Evaluation Hearing Loss Occupational Cancer Dermatology Reproduction Mining Solvents What can an individual do? Look at abilities, not disabilities Occupational cancer is more important and varied Evaluations above ground and under ground are different

ISSUES Continued Pesticides Gases Sick Building Syndrome Biologic Monitoring Substance Abuse Chemicals Industry Pesticides can affect everyone, not just workers Cause of Sick Building Syndrome are varied and many Biological monitoring has its plus and minuses Each industry has its own issues

ISSUES continued Back Pain Radiation Metals Life Styles Occupational Stress Americans with Disabilities Act Business Community Back pain is a difficult problem with many etiologies Metal intoxication is an ongoing problem Lifestyles changed and the associated problems have also changed Occupational stress will increase in the coming years

ISSUES CONTINUED Pulmonary Disease Neurotoxic Disorders Emergency Response Computerized Medical Record Shift Work Shift work covers more working people today Emergency response includes Bioterrorism Many substances are neurotoxic and more are being found Without computers issues cannot be adequately followed