is work making your patients ill? work and disease grant mcmillan hon senior clinical lecturer...

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