RECOGNITION OF OCCUPATIONAL AND ENVIRONMENTAL DISEASES

Chapter 9 - Environmental and Nutritional Pathology

Agnes B. Kane MD, PhD

Vinay Kumar MD

Environment and Disease

Environmental and occupational health encompasses the diagnosis, treatment, and prevention of injuries and illnesses resulting from exposure to exogenous chemical or physical agents.

Such exposure may occur in the workplace, or people may voluntarily expose themselves to these hazards, for example, by abusing drugs or ethanol and smoking cigarettes. These personal

habits may lead to involuntary exposure of fetuses and infants to drugs, ethanol, or environmental tobacco smoke.

People are often confused about the magnitude of the adverse health effects of exogenous physical and chemical agents. There is widespread concern about the potential chronic or delayed

effects of exposure to low levels of contaminants in air, water, and food, and hence patients frequently seek advice and information from their health care

professionals about the risk of disease associated with specific environmental and occupational exposures. This chapter provides a basic foundation in the most important diseases

associated with environmental and occupational exposures, emphasizing the mechanisms leading to these diseases. This framework will help physicians to recognize and treat injuries and

illness resulting from environmental and occupational exposures and to educate their patients about the risks of these exposures.[1]

RECOGNITION OF OCCUPATIONAL AND ENVIRONMENTAL DISEASES

Accidents, illness, and premature deaths threaten the health of 130 million workers in the United States. Occupational health risks are even greater in developing countries, where children

and women constitute a larger proportion of the work force. In the United States, the annual rate of occupational injuries is 7400 per 100,000 workers. The overall fatality rate is 4.8 per

100,000 workers; the highest rates occur in the mining, agricultural, construction, transportation, and public utility industries. In addition to physical injury, occupational exposures

contribute to a wide range of illnesses that may lead to premature death ( Table 9-1 ). The magnitude of occupational diseases is most likely underestimated because workers and their

employers fear economic or legal pressures, physicians may not recognize that an illness is work related, and there may be a long latent period between exposure and the development of

clinical illness. Nevertheless, occupational diseases are preventable if there is adequate surveillance by state and federal governments, responsible leadership in industry, and access to

health professionals trained in occupational safety and health.[1]

The magnitude and extent of illness related to environmental exposures are difficult to ascertain. The Environmental Protection Agency estimates that more than 80,000 chemicals are

currently used in the United States; approximately 1500 are pesticides and 5500 are food additives that affect our water and food supplies. Although only 600 of these chemicals have been

tested, 10% have produced cancer in at least one rodent species.[2] Industrial chemicals, production

TABLE 9-1-- Reported Occupational Diseases in the United States in 1997

Date: 2016-04-22; view: 949