Occupational Health Practice by R. S. F. Schilling (Eds.)

By R. S. F. Schilling (Eds.)

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For example, at one factory the repeated attendance for treatment of backache by men from one department revealed that they were using the wrong methods for loading trucks. Advanced epidemiological 43 FUNCTIONS OF AN OCCUPATIONAL HEALTH SERVICE methods can also be applied to the records of injuries and disease to determine more obscure causal factors in the working environment (see Chapter 8). As well as safeguarding workers from physical hazards, the treatment service also provides evidence which leads to the identification of psycho-social factors causing ill health (see Chapter 11).

Genetic factors. - Advances in genetics over the last few decades raise possibilities for the screening out of susceptibles from situations which could be especially dangerous to them. Some examples are as follows. ( 1 ) Subjects with methaemoglobinaemia should avoid occupational exposure to hydrogen sulphide. (2) Cholinesterase-deficient subjects should avoid contact with organophosphorous compounds either in manufacture or use. (3) Subjects with defective hepatic glucuronation such as in Crigler-Najjar disease might be particularly susceptible to certain industrial poisons such as poly cyclic hydrocarbons which are detoxicated in the liver by conjugation with glucuronic acid.

He will also have to be aware of the varying effects on man of substitution and addition of various radicals onto the aromatic side chains. But this knowledge is not necessary for a medical officer in a coal mine. Nevertheless, it is useful for physicians practising among industrialized communities to keep in mind the occupational causes for the most common symptom-complexes so that their occurrence in a patient may suggest a possible occupational aetiology. A few examples demonstrate this point.

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