PRINCIPLES OF TOXICOLOGY - Biology East Borneo

20 Occupational and EnvironmentalHealthOCCUPATIONAL AND ENVIRONMENTAL HEALTHFREDRIC GERR, EDWARD GALAID, and HOWARD FRUMKINThe objectives of this chapter are to introduce the medical specialty called occupational and environmentalmedicine, 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 care20.1 DEFINITION AND SCOPE OF THE PROBLEMHazards can be found in the workplace and the non-work environment that increase the risk of bothillness and injury. Illness tends to develop over time following repeated exposure to a hazard whereasinjury usually occurs instantly. Because this textbook focuses on toxicology, the main focus of thischapter 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 andjudgment.Occupational illness and environmental illness are adverse health conditions, the occurrence orseverity of which is related to exposure to factors on the job or in the nonwork environment. Suchfactors 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 illnessinclude1. Scarring of the lungs following inhalation of airborne asbestos dust fibers among insulationworkers2. Loss of memory following long-term exposure to organic solvents among spray painters3. Headache, low blood counts (anemia), and abdominal pain following exposure to lead amongbattery workers4. Hearing loss among noise-exposed textile plant workers5. Hepatitis B infection following needlestick accidents among health care workers in a hospital6. Neck and shoulder pain among journalists with intense deadline pressuresThe 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