Occupational History Occupational History Taking and Physical Taking and Physical

ExaminationsExaminations

A. H. MehrparvarA. H. Mehrparvar

Yazd University of medical sciencesYazd University of medical sciences

Occupational HistoryOccupational History

Present jobPresent job Previous jobsPrevious jobs Duration of employmentDuration of employment Occupational exposuresOccupational exposures Specific tasksSpecific tasks Non-occupational exposuresNon-occupational exposures Personal factorsPersonal factors

Occupational Occupational ExaminationsExaminations

Pre-placementPre-placement Fitness for workFitness for work PeriodicPeriodic Return to workReturn to work ExitExit SpecificSpecific

Agricultural Work:Agricultural Work:Occupational DiseasesOccupational Diseases

IntroductionIntroduction

Agricultural work seems a Agricultural work seems a safe and healthy job:safe and healthy job:- weather- weather- less pollution- less pollution

High incidence of morbidity High incidence of morbidity and mortalityand mortality

One of the most hazardous jobsOne of the most hazardous jobs

IntroductionIntroduction

A unique industry:A unique industry:

- Workers in all ages- Workers in all ages

- Constant, seasonal and migrant - Constant, seasonal and migrant workers workers

- Farm as worksite and home- Farm as worksite and home

- Working extra times- Working extra times

Occupational hazardsOccupational hazards

Physical Physical ChemicalChemical BiologicBiologic ErgonomicErgonomic AccidentsAccidents

Physical hazardsPhysical hazards

HeatHeat

- Heat stroke- Heat stroke Sunlight (UV)Sunlight (UV)

- Dermatitis- Dermatitis

- Cancer- Cancer Noise (equipment, Vehicles)Noise (equipment, Vehicles)

Chemical hazardsChemical hazards

Pesticides:Pesticides:

- Organophosphates- Organophosphates

- Carbamates- Carbamates

- Organochlorines- Organochlorines FertilizersFertilizers Nitrogen oxidesNitrogen oxides

Biologic hazardsBiologic hazards

Infectious diseases Infectious diseases (Zoonosis):(Zoonosis):

- Brucelosis- Brucelosis

- Leptospirosis- Leptospirosis

- Anthrax- Anthrax

- Toxoplasmosis- Toxoplasmosis

Ergonomic hazardsErgonomic hazards

LiftingLifting Bending and twisting of trunkBending and twisting of trunk Repetitive work by hands Repetitive work by hands

(e.g. picking)(e.g. picking) Awkward postures (Kneeling, Awkward postures (Kneeling,

Squatting, Overhead work, …)Squatting, Overhead work, …)

AccidentsAccidents

A high frequency of accidentsA high frequency of accidents

- minor trauma (laceration, …)- minor trauma (laceration, …)

- Major trauma- Major trauma

Special diseasesSpecial diseases

TraumaTrauma Respiratory diseasesRespiratory diseases Skin diseasesSkin diseases CancersCancers InfectionsInfections Musculoskeletal diseasesMusculoskeletal diseases

TraumaTrauma

EquipmentsEquipments Falling objectsFalling objects VehiclesVehicles Falling Falling DrowningDrowning AnimalsAnimals

Respiratory diseasesRespiratory diseases

Organic dust toxic syndrome Organic dust toxic syndrome (ODTS)(ODTS)

Chronic BronchitisChronic Bronchitis AsthmaAsthma Farmers’ lung (Hypersensitivity Farmers’ lung (Hypersensitivity

pneumonitis)pneumonitis) Silo Fillers’ diseaseSilo Fillers’ disease

Skin diseasesSkin diseases

Dermatitis:Dermatitis:- ACD, ICD- ACD, ICD

- Due to: Sunlight, Pesticides, Corps, - Due to: Sunlight, Pesticides, Corps, livestock, Aslivestock, As

CancersCancers

CancersCancers

Causes:Causes:

- UV- UV

- Chemicals (pesticides, …)- Chemicals (pesticides, …) Types:Types:

- Skin (SCC, BCC, Melanoma)- Skin (SCC, BCC, Melanoma)

- Lymphatic- Lymphatic

- Hematopoietic- Hematopoietic

- Stomach, Brain, Prostate- Stomach, Brain, Prostate

MSDsMSDs

Low back painLow back pain Repetitive strain injuriesRepetitive strain injuries

Physical examinationPhysical examination

Respiratory systemRespiratory system Musculoskeletal systemMusculoskeletal system SkinSkin Nervous system Nervous system

Carpet Weavers:Carpet Weavers:Occupational diseasesOccupational diseases

IntroductionIntroduction

A unique industry:A unique industry:

- Workers in all ages- Workers in all ages

- Constant, seasonal and migrant - Constant, seasonal and migrant workers workers

- Same worksite and home- Same worksite and home

- Working extra times- Working extra times

Occupational hazardsOccupational hazards

Chemical (organic dust)Chemical (organic dust) Biologic (infectious agents)Biologic (infectious agents) Ergonomic (prolonged sitting, Ergonomic (prolonged sitting,

static work, awkward posture)static work, awkward posture)

Specific diseasesSpecific diseases

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

ExaminationsExaminations

Musculoskeletal systemMusculoskeletal system EyeEye SkinSkin Respiratory systemRespiratory system