PRINCIPLES OF TOXICOLOGY

20 Occupational and Environmental
Health
OCCUPATIONAL AND ENVIRONMENTAL HEALTH
FREDRIC GERR, EDWARD GALAID, and HOWARD FRUMKIN
The objectives of this chapter are to introduce the medical specialty called occupational and environmental
medicine, its goals and methods. This chapter
• Defines, categorizes, and quantifies occupational and environmental diseases
• Describes the professions that work in occupational health care
• Describes the activities of occupational health care, including diagnosis and treatment,
screening and surveillance, evaluation for attribution, and training and education
• Describes the settings in which occupational and environmental medicine is practiced
• Introduces ethical issues that arise in delivering occupational and environmental health care
20.1 DEFINITION AND SCOPE OF THE PROBLEM
Hazards can be found in the workplace and the non-work environment that increase the risk of both
illness and injury. Illness tends to develop over time following repeated exposure to a hazard whereas
injury usually occurs instantly. Because this textbook focuses on toxicology, the main focus of this
chapter will be on occupational illness resulting from chemical exposure. Some chemical exposures,
however, such as organic solvents can increase the risk of injury by impairing coordination and
judgment.
Occupational illness and environmental illness are adverse health conditions, the occurrence or
severity of which is related to exposure to factors on the job or in the nonwork environment. Such
factors can be chemical (solvents, pesticides, heavy metals), physical (heat, noise, radiation), biological
(tuberculosis, hepatitis B virus, HIV) or psychosocial/organizational stressors (machine pacing,
piecework, lack of control over work, inadequate personal support). Examples of occupational illness
include
1. Scarring of the lungs following inhalation of airborne asbestos dust fibers among insulation
workers
2. Loss of memory following long-term exposure to organic solvents among spray painters
3. Headache, low blood counts (anemia), and abdominal pain following exposure to lead among
battery workers
4. Hearing loss among noise-exposed textile plant workers
5. Hepatitis B infection following needlestick accidents among health care workers in a hospital
6. Neck and shoulder pain among journalists with intense deadline pressures
The leading categories of work-related diseases are presented in Table 1.
Principles of Toxicology: Environmental and Industrial Applications, Second Edition, Edited by Phillip L. Williams,
Robert C. James, and Stephen M. Roberts.
ISBN 0-471-29321-0 © 2000 John Wiley & Sons, Inc.
499