1. Occupational History and Examination
H.R.Sarreshtahdar, MD
Occupational Medicine Specialist

2. Occupational history Symptoms Exposure
Most important tool for the diagnosis of occupational illness
Symptoms
Exposure

3. Occupational history Problems: Important issues:
Time constraints for workers and physicians
Enormous range of known and potential toxic exposures
Important issues:
All jobs held and approximate date of employment
Job title is not sufficient
Significant changes in job duties
Second job

4. Occupational history Exposure history Environmental history
Have you ever worked with or been exposed to any of the following substances?
Environmental history
Water source, heating source, pets, proximity to industries, hobbies

5. Health in Relation To Work
Relationship between symptoms and time of work shifts or specific exposures.
Similar complaints among coworkers.
Compensation

6. Patient Management The diagnostic period
Formulation of treatment plans
Communication
Follow up

7. Types of examinations Pre-placement examinations
Medical screening and surveillance examinations
Return to work assessment
Exit examinations
Evaluation for specific occupational exposures or diseases
Fitness for work assessment

8. Pre-placement examinations
Most common and least specific.
Assess a candidate’s suitability for a job.
Need detailed description of the essential functions of the job.
Do not easily exclude a worker from a job.
Exclusion of the worker if he can not perform only essential functions of the job.

9. Surveillance examinations (Periodic)
Screening tests are tools for secondary prevention
In occupational medicine may be a tool for primary prevention
Target-organ or substance-specific
More focused than pre-placement examination
Detect early disease
Medical screening is not a substitute for hazard control

10. Return to work examinations
Assess individuals before returning to work after a period of absence from:
Occupational causes
Non-occupational causes
Assess fitness for work
Need detailed information about job requirements
An interaction between physician, industrial hygienist, ergonomist, and engineer to safely return the worker to the work.

11. Exit examinations
Structure and content similar to periodic examinations
Target-organ or substance specific
The least common occupational examinations
Shows any adverse occupational health effects before leaving the work

12. Any question?
Thanks For Attention