Landrigan P J, Baker D B
Department of Community Medicine, Mount Sinai School of Medicine, New York, NY.
JAMA. 1991 Aug 7;266(5):676-80.
Occupational diseases account each year in the United States for an estimated 50,000 to 70,000 deaths and 350,000 new cases of illness. Often, however, occupational diseases are not correctly diagnosed, because they mimic diseases due to other causes and because most physicians are not well trained in their recognition. Opportunities for prevention and treatment are therefore lost. The occupational history is the most effective means for proper diagnosis of occupational illness. It should routinely be obtained for every patient. A brief but systematic guide for obtaining an occupational history is presented in this report. Also, approaches are summarized for the recognition and diagnosis of such important occupational diseases as occupational cancer, asbestosis and other respiratory disorders, and occupational neuropsychologic disorders. The management and prevention of occupational diseases depend on reduction of hazardous exposures in the workplace and better education of workers, industrial managers, and physicians. This report outlines a program for the control of occupational disease based on (1) preventing exposures in the workplace, (2) premarket toxicity testing of new chemicals and technologies, and (3) astute clinical diagnosis.
在美国，职业病每年估计导致5万至7万人死亡，并有35万新发病例。然而，职业病常常得不到正确诊断，因为它们与其他病因引起的疾病相似，而且大多数医生在识别方面未接受过良好培训。因此，失去了预防和治疗的机会。职业病史是正确诊断职业病的最有效手段。应该为每位患者常规获取职业病史。本报告提供了一份获取职业病史的简短但系统的指南。此外，还总结了识别和诊断重要职业病的方法，如职业性癌症、石棉沉着病和其他呼吸系统疾病，以及职业性神经心理障碍。职业病的管理和预防取决于减少工作场所的有害暴露，以及对工人、企业管理人员和医生进行更好的教育。本报告概述了一项职业病控制计划，该计划基于以下几点：（1）防止工作场所暴露；（2）对新化学品和新技术进行上市前毒性测试；（3）敏锐的临床诊断。
