James Efia, Linde Brian, Redlich Carrie A
Department of Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, 367 Cedar Street, ESHA 2nd Floor, New Haven, CT 06510, USA.
Department of Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, 367 Cedar Street, ESHA 2nd Floor, New Haven, CT 06510, USA.
Clin Chest Med. 2020 Dec;41(4):567-580. doi: 10.1016/j.ccm.2020.08.019.
Occupational and environmental exposures contribute to the development and progression of most lung diseases, yet their impact is greatly under-recognized in clinical practice. Clinicians caring for patients with respiratory diseases should maintain a high index of suspicion for occupational and environmental contributing factors. Mastering occupational and environmental medicine clinical decision making requires specialized clinical skills. These skills include obtaining an appropriate work and exposure history; making an assessment of the magnitude and relevance of exposures and their contribution to a patient's respiratory disease; utilizing appropriate resources for evaluation and management of exposure-related disease; and considering socioeconomic and public health factors.
职业和环境暴露会促使大多数肺部疾病的发生和发展，然而在临床实践中，它们的影响却极大地未得到充分认识。诊治呼吸系统疾病患者的临床医生应高度怀疑职业和环境因素的作用。掌握职业和环境医学的临床决策需要专门的临床技能。这些技能包括获取恰当的工作和暴露史；评估暴露的程度及相关性及其对患者呼吸系统疾病的影响；利用适当资源评估和管理与暴露相关的疾病；以及考虑社会经济和公共卫生因素。
