The Primary Care Practitioner and the diagnosis of occupational diseases
1 Padua University, Department of Environmental Medicine and Public Health, Padua, Italy
2 Imperial College London, School of Public Health, St Mary's Campus, Norfolk Place, London, UK
3 Envirosafe Training and Consultants, Pittsburgh, Pennsylvania, USA
BMC Public Health 2010, 10:405 doi:10.1186/1471-2458-10-405Published: 9 July 2010
Rather than a clinical diagnosis, in occupational medicine the critical point is the etiological diagnosis. The first is useful for the therapy, the latter for preventive, epidemiological, regulatory, and insurance measures.
As with causality criteria which are employed in population studies, the answering of four easy questions allows a Primary Care Practitioner to establish a causal link between the work activities and a potential disease that a specific patient may present.
After determining the clinical diagnosis and the actual pathology of an occupational disease, the identity, duration, and intensity of the exposure have to be detected for establishing a close-causal effect. The judgment on the occupational origin of the disease requires an integrated approach using multiple sources of information, and goes beyond the clinical diagnosis. This may require consultation with a specialist in occupational medicine.
It is important that the Primary Care Practitioner takes an accurate medical history since this may be the only chance a patient has to have their occupational disease recognised and properly detected/identified. Proper identification of the causative nature of such diseases is important for establishing preventive measures in eliminating and controlling future cases against exposure, epidemiological reporting and studies (particularly in identifying the rates of disease), regulatory reporting requirements and insurance compensation.