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Overview of occupational and environmental health

Rose H Goldman, MD, MPH
Section Editor
Joann G Elmore, MD, MPH
Deputy Editor
H Nancy Sokol, MD


Environmental and occupational issues have an important place in primary care practice, emergency medicine, pediatrics, and various medical specialties. Work or environmental exposures may be linked to an individual patient's symptoms. A patient's reported environmental exposures may prompt important interventions to prevent future illnesses or injuries, and work-related injuries or illnesses may require physicians to make assessments of impairment, disability, and workers' compensation.

Concerns about chemical or biological terrorism, as well as industrial disasters, have made it imperative that physicians be able to immediately recognize patterns associated with exposures to key chemical agents (such as cyanide and nerve agents) and biological agents (such as anthrax) [1]. (See "Chemical terrorism: Rapid recognition and initial medical management" and "Identifying and managing casualties of biological terrorism".) In addition, health care providers and health centers need to have sufficient background to be able to respond to patients with potential exposures from accidental contaminations of drinking water or air, or exposures related to new technologies, such as fracking.

To be effective, physicians need to know how to take a good environmental/occupational history and have a reasonable understanding of common environmentally related illnesses and basics of exposure assessment [2]. In addition, physicians can play an important role in occupational and environmental issues that extend beyond the office practice, preventing occupational illness in other employees at the work site and promoting general global environmental health [3,4].

An overview of occupational and environmental health is found here. Occupational lung disease is discussed in detail separately, as is adult lead poisoning, arsenic toxicity, and female reproductive toxicity. (See "Occupational asthma: Definitions, epidemiology, causes, and risk factors" and "Adult occupational lead poisoning" and "Arsenic exposure and poisoning" and "Occupational and environmental risks to reproduction in females".)


The full extent of occupational injuries and illness is difficult to measure. In the United States (US), the Bureau of Labor Statistics (BLS), which details statistics based upon surveys of private companies (an underestimate of the true totals), reported that in 2012 there were 4693 fatal work-related accidents (3.2 per 100,000) [5] and 3 million nonfatal injuries and illnesses, or 3.4 per 100 equivalent full-time workers [6]. More than one half of the 3.0 million cases reported were of a more serious nature that involved required days away from work, job transfer, or restricted duties at work.


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Literature review current through: Sep 2016. | This topic last updated: Apr 2, 2015.
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