Occupational History Taking and Physical Examinations A. H. Mehrparvar Yazd University of medical sciences

Occupational History Present job Present job Previous jobs Previous jobs Duration of employment Duration of employment Occupational exposures Occupational exposures Specific tasks Specific tasks Non-occupational exposures Non-occupational exposures Personal factors Personal factors

Occupational Examinations Pre-placement Pre-placement Fitness for work Fitness for work Periodic Periodic Return to work Return to work Exit Exit Specific Specific

Agricultural Work: Occupational Diseases

Introduction Agricultural work seems a safe and healthy job: Agricultural work seems a safe and healthy job: - weather - less pollution High incidence of morbidity and mortality High incidence of morbidity and mortality One of the most hazardous jobs One of the most hazardous jobs

Introduction A unique industry: A unique industry: - Workers in all ages - Constant, seasonal and migrant workers - Farm as worksite and home - Working extra times

Occupational hazards Physical Physical Chemical Chemical Biologic Biologic Ergonomic Ergonomic Accidents Accidents

Physical hazards Heat Heat - Heat stroke Sunlight (UV) Sunlight (UV) - Dermatitis - Cancer Noise (equipment, Vehicles) Noise (equipment, Vehicles)

Chemical hazards Pesticides: Pesticides: - Organophosphates - Carbamates - Organochlorines Fertilizers Fertilizers Nitrogen oxides Nitrogen oxides

Biologic hazards Infectious diseases (Zoonosis): Infectious diseases (Zoonosis): - Brucelosis - Leptospirosis - Anthrax - Toxoplasmosis

Ergonomic hazards Lifting Lifting Bending and twisting of trunk Bending and twisting of trunk Repetitive work by hands (e.g. picking) Repetitive work by hands (e.g. picking) Awkward postures (Kneeling, Squatting, Overhead work, … ) Awkward postures (Kneeling, Squatting, Overhead work, … )

Accidents A high frequency of accidents A high frequency of accidents - minor trauma (laceration, … ) - Major trauma

Special diseases Trauma Trauma Respiratory diseases Respiratory diseases Skin diseases Skin diseases Cancers Cancers Infections Infections Musculoskeletal diseases Musculoskeletal diseases

Trauma Equipments Equipments Falling objects Falling objects Vehicles Vehicles Falling Falling Drowning Drowning Animals Animals

Respiratory diseases Organic dust toxic syndrome (ODTS) Organic dust toxic syndrome (ODTS) Chronic Bronchitis Chronic Bronchitis Asthma Asthma Farmers ’ lung (Hypersensitivity pneumonitis) Farmers ’ lung (Hypersensitivity pneumonitis) Silo Fillers ’ disease Silo Fillers ’ disease

Skin diseases Dermatitis: Dermatitis: - ACD, ICD - Due to: Sunlight, Pesticides, Corps, livestock, As Cancers Cancers

Cancers Causes: Causes: - UV - Chemicals (pesticides, … ) Types: Types: - Skin (SCC, BCC, Melanoma) - Lymphatic - Hematopoietic - Stomach, Brain, Prostate

MSDs Low back pain Low back pain Repetitive strain injuries Repetitive strain injuries

Physical examination Respiratory system Respiratory system Musculoskeletal system Musculoskeletal system Skin Skin Nervous system Nervous system

Carpet Weavers: Occupational diseases

Introduction A unique industry: A unique industry: - Workers in all ages - Constant, seasonal and migrant workers - Same worksite and home - Working extra times

Occupational hazards Chemical (organic dust) Chemical (organic dust) Biologic (infectious agents) Biologic (infectious agents) Ergonomic (prolonged sitting, static work, awkward posture) Ergonomic (prolonged sitting, static work, awkward posture)

Specific diseases Pulmonary (asthma, ODTS, … ) Pulmonary (asthma, ODTS, … ) Infectious (anthrax) Infectious (anthrax) Skin (dermatitis) Skin (dermatitis)

Examinations Musculoskeletal system Musculoskeletal system Eye Eye Skin Skin Respiratory system Respiratory system