Occupational diseases and taking an occupational history

Issue: BCMJ, vol. 63, No. 2, March 2021, Page 73 WorkSafeBC
By: Olivia Sampson, MD, CCFP, MPH, FRCPC, ABPM

Many family physicians or primary care providers will see occupational diseases in their daily practice. Physicians can play an important role in the prevention and early recognition of occupational diseases. Recognizing these diseases can be challenging for a variety of reasons, including the long latency period between some exposures and disease onset and the multifactorial nature of these diseases.[1]

Occupational diseases can be caused or exacerbated by conditions in the workplace. Some examples of occupational diseases include noise-induced hearing loss, respiratory diseases (e.g., asbestosis, silicosis, occupational asthma or COPD, occupational allergic rhinitis), cancers (e.g., mesothelioma, lung cancer), chemical or heavy metal poisoning (e.g., carbon monoxide, lead, mercury, cadmium), skin conditions (e.g., allergic or irritant contact dermatitis, cancers), and infectious diseases (e.g., HBV from blood and body fluid exposures, TB, zoonotic diseases).

You can help your patients navigate through WorkSafeBC by incorporating occupational screening questions into your patient history. This helps identify potential exposures in the workplace that may be contributing to your patients’ symptoms. Some useful questions include:[1]

  1. What kind of work do you do? How do you do your work?
  2. Are your symptoms better at home or worse when you are work?
  3. Are you now or have you previously been exposed to dust, fumes, chemicals, radiation, infectious diseases, or loud noise at your workplace?
  4. Do you think your health problems are related to your work? Why?
  5. Do other workers have similar symptoms associated with the same exposure?

A more detailed occupational history should include:[1]

  1. Documenting your patients’ past and present employment history.
  2. Identifying the types of exposures at workplaces, which may be biological, chemical, physical, or psychological.
  3. Assessing exposure by asking:
  • For safety data sheets, what substances the patient works with.
  • About the frequency and quantity of exposures.
  • Where they were working in relation to the exposures and the duration of the exposures.
  • What types of controls are present at work (e.g., ventilation, personal protective equipment such as respirators or gloves, hand washing).
  • How they may be exposed at work (e.g., skin contact, inhalation, or ingestion while eating).
  1. Documenting nonoccupational exposures (e.g., hobbies, pets, smoking, travel, home renovations).[2]

If a patient develops a disease and you or they are concerned that the disease may be work related, a claim can be initiated by submitting a Form 8 to WorkSafeBC. WorkSafeBC claims require a medical diagnosis submitted by a physician or other qualified practitioner. Your patient’s claim will be reviewed by Occupational Disease Services, a specialized claims unit of WorkSafeBC. There are two main requirements for an occupational disease to be considered work related by WorkSafeBC: the disease must be recognized by WorkSafeBC as an occupational disease and the disease must be due to the nature of your patient’s current or past employment.

If WorkSafeBC accepts your patient’s claim as an occupational disease, then they may be eligible for benefits and services, which can include compensation for lost wages, coverage of health care costs, support with rehabilitation, or a permanent disability benefit. If your patient’s disease is due to the nature of their employment but they have not lost time from work, they can still claim for medical costs and treatment for the occupational disease. If your patient has a terminal illness or passes away from an accepted occupational disease, your patient’s spouse or dependents may be eligible for compensation benefits.
—Olivia Sampson, MPH, FRCPC, ABPM, CCFP

Further information

  1. If you or your patients are concerned about occupational exposures or safety in the workplace, contact WorkSafeBC Prevention at 604 276-3100.
  2. If you or a patient has concerns about an exposure at their workplace but your patient is well, you or your patient can register the exposure on the Exposure Registry at www.worksafebc.com/en/resources/health-care-providers/forms/exposure-registry-program-form-41m1?lang=en.
  3. If you have questions about an occupational disease, call 604 231-8842 and request to speak to an occupational disease services medical advisor or visit www.worksafebc.com/en/claims/report-workplace-injury-illness/types-of-claims/occupational-diseases.

hidden

This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.

References

1.    Taiwo O, Mobo BH, Cantley L. Recognizing occupational illnesses and injuries. Am Fam Physician 2010;82:169-174.

2.    College of Family Physicians of Canada. Occupational medicine clinical snippet, August 2016: Taking an occupational history. Accessed 25 January 2021. https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Directories/Committees_List/2016-08%20Taking%20an%20Occupational%20History%20(Final).pdf.

Olivia Sampson, MD, CCFP, MPH, FRCPC, ABPM. Occupational diseases and taking an occupational history. BCMJ, Vol. 63, No. 2, March, 2021, Page(s) 73 - WorkSafeBC.


Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply