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Occupational History Taking and Physical Examinations A. H. Mehrparvar Yazd University of medical sciences Occupational History Present job Previous jobs Duration of employment Occupational exposures Specific tasks Non-occupational exposures Personal factors Occupational Examinations Pre-placement Fitness for work Periodic Return to work Exit Specific Agricultural Work: Occupational Diseases Introduction Agricultural work seems a safe and healthy job: - weather - less pollution High incidence of morbidity and mortality One of the most hazardous jobs Introduction A unique industry: - Workers in all ages - Constant, seasonal and migrant workers - Farm as worksite and home - Working extra times Occupational hazards Physical Chemical Biologic Ergonomic Accidents Physical hazards Heat - Heat stroke Sunlight (UV) - Dermatitis - Cancer Noise (equipment, Vehicles) Chemical hazards Pesticides: - Organophosphates - Carbamates - Organochlorines Fertilizers Nitrogen oxides Biologic hazards Infectious diseases (Zoonosis): - Brucelosis - Leptospirosis - Anthrax - Toxoplasmosis Ergonomic hazards Lifting Bending and twisting of trunk Repetitive work by hands (e.g. picking) Awkward postures (Kneeling, Squatting, Overhead work, …) Accidents A high frequency of accidents - minor trauma (laceration, …) - Major trauma Special diseases Trauma Respiratory diseases Skin diseases Cancers Infections Musculoskeletal diseases Trauma Equipments Falling objects Vehicles Falling Drowning Animals Respiratory diseases Organic dust toxic syndrome (ODTS) Chronic Bronchitis Asthma Farmers’ lung (Hypersensitivity pneumonitis) Silo Fillers’ disease Skin diseases Dermatitis: - ACD, ICD - Due to: Sunlight, Pesticides, Corps, livestock, As Cancers Cancers Causes: - UV - Chemicals (pesticides, …) Types: - Skin (SCC, BCC, Melanoma) - Lymphatic - Hematopoietic - Stomach, Brain, Prostate MSDs Low back pain Repetitive strain injuries Physical examination Respiratory system Musculoskeletal system Skin Nervous system Carpet Weavers: Occupational diseases Introduction A unique industry: - Workers in all ages - Constant, seasonal and migrant workers - Same worksite and home - Working extra times Occupational hazards Chemical (organic dust) Biologic (infectious agents) Ergonomic (prolonged sitting, static work, awkward posture) Specific diseases Pulmonary (asthma, ODTS, …) Infectious (anthrax) Skin (dermatitis) Examinations Musculoskeletal system Eye Skin Respiratory system