Felton J S
J Fam Pract. 1980 Jul;11(1):33-9.
The need for detailed occupational histories has been demonstrated by the occurrence of 100,000 deaths from, and 390,000 new cases of, occupational disease each year. Work generated illness takes the form of serious involvement of all bodily organ systems and, in addition, can present as the ill effects of carcinogenesis, mutagenesis, and teratogenesis. Monographic writings on physical diagnosis and family medicine have failed to give emphasis to a substantial description of the patient's employment and its health effects. Such a complete occupational medical history has as its primary objectives the improvement of medical care and the return of the worker to gainful employment. The elaboration of such a history involves inquiry into all past work performed, the development of symptoms, the health of fellow workers, and knowledge of the preventive medical program offered at the worksite. A detailed work history will aid the primary care physician in the rendering of more intelligent preventive medical attention to the wage earner-patient.
每年有10万人死于职业病，39万例职业病新发病例，这表明了详细职业病史的必要性。工作引发的疾病表现为身体所有器官系统的严重受累，此外，还可能表现为致癌、致突变和致畸的不良影响。关于物理诊断和家庭医学的专著未能着重对患者的职业及其对健康的影响进行充分描述。这样完整的职业病史的主要目标是改善医疗护理，并使工人恢复有报酬的工作。详细阐述这样的病史需要询问过去从事的所有工作、症状的发展、同事的健康状况以及对工作场所提供的预防医疗计划的了解。详细的工作史将有助于初级保健医生为挣工资的患者提供更明智的预防性医疗护理。
