Items in AFP with MESH term: Accidents, Occupational
Work-Related Eye Injuries and Illnesses - Article
ABSTRACT: More than 65,000 work-related eye injuries and illnesses, causing significant morbidity and disability, are reported in the United States annually. A well-equipped eye tray includes fluorescein dye, materials for irrigation and foreign body removal, a short-acting mydriatic agent, and topical anesthetics and antibiotics. The tray should be prepared in advance in case of an eye injury. Eye patching does not improve cornea reepithelialization or discomfort from corneal abrasions. Blunt trauma to the eye from a heavy object can cause a blow-out fracture. Sudden eye pain after working with a chisel, hammer, grinding wheel, or saw suggests a penetrating globe injury. Chemical eye burns require immediate copious irrigation. Nontraumatic causes of ocular illness are underreported; work-related allergic conjunctivitis increasingly has been recognized among food handlers and agriculture workers who are exposed to common spices, fruits, and vegetables. The patient's history of eye injury guides the diagnosis. Primary prevention and patient counseling on proper eye protection is essential because over 90 percent of injuries can be avoided with the use of eye protection. As laser use increases in industry and medical settings, adequate personal protection is needed to prevent cataracts. Outdoor workers exposed to significant ultraviolet rays need sun protection and safety counseling to prevent age-related macular degeneration. Contact lenses do not provide eye protection, and physicians should be familiar with guidelines for the use of contacts in the workplace.
ABSTRACT: Given the burden of occupational illnesses and injuries in the United States, family physicians should understand the role workplace exposures may play in patients' chief concerns. Incorporating employment screening questions into patients' intake questionnaires is an efficient means of identifying potential occupational causes of symptoms. Recommended questions include what kind of job patients have; whether their symptoms are worse at work; whether they are or have been exposed to dust, fumes, chemicals, radiation, or loud noise; and whether they think their health problems may be related to their work. These questions are especially important when the diagnosis or etiology is in doubt. Depending on patients' responses to the screening questions, a more detailed occupational history may be appropriate. It can be useful to ask about routine tasks performed during a typical work shift, as well as anything out of the ordinary (e.g., a change in routine, an injury or accident). The occupational history should include information about alcohol and tobacco use, second or part-time jobs, military service, hobbies, and home environment. Patients with suspected occupational illnesses or injuries may benefit from referral to an occupational medicine specialist for a more detailed assessment and follow-up.
Pre-employment Examinations for Preventing Occupational Injury and Disease - Cochrane for Clinicians
ABSTRACT: Approximately 3 million work-related injuries were reported by private industries in 2011, and primary care physicians provided care for approximately one out of four injured workers. To appropriately individualize the treatment of an injured worker and expedite the return to work process, primary care physicians need to be familiar with the workers’ compensation system and treatment guidelines. Caring for an injured worker begins with a medical history documenting preexisting medical conditions, use of potentially impairing medications and substances, baseline functional status, and psychosocial factors. An understanding of past and current work tasks is critical and can be obtained through patient-completed forms, job analyses, and the patient’s employer. Return to work in some capacity is an important part of the recovery process. It should not be unnecessarily delayed and should be an expected outcome communicated to the patient during the initial visit. Certain medications, such as opioids, may delay the return to work process, and their use should be carefully considered. Accurate and legible documentation is critical and should always include the location, date, time, and mechanism of injury.