1. Is work making your patients ill? Work and disease Grant McMillan Hon Senior Clinical Lecturer Institute of Occupational and Environmental Health University of Birmingham Number 8 of a series of lectures and tutorials for medical undergraduates

2. Learning points Range of adverse effects of workRange of adverse effects of work on individuals in common occupations on individuals in common occupations Importance of considering occupationImportance of considering occupation when seeking a diagnosis or a remedy when seeking a diagnosis or a remedy Readily accessible sources of information about occupational diseaseReadily accessible sources of information about occupational disease

3. Categories of work-related diseases IWork the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

4. Learning points Range of adverse effects of workRange of adverse effects of work on individuals in common occupations on individuals in common occupations Importance of considering occupationImportance of considering occupation when seeking a diagnosis or a remedy when seeking a diagnosis or a remedy Readily accessible sources of information about occupational diseaseReadily accessible sources of information about occupational disease

5. Work the cause TannerTanner BricklayerBricklayer Needle gun operatorNeedle gun operator Chrome platerChrome plater

6. Work the cause Work the cause - tanning animal hides Hazard and effect?

7. Clue! Can also be hazard to postal workers

8. Work the cause Work the cause - tanning animal hides Hazard - Bacillus Anthracis

9. Work the cause Work the cause - tanning animal hides Effect - cutaneous anthrax. There is also a pulmonary form.

10. Work the cause Work the cause - bricklaying - Hazard and effect?

11. Work the cause Work the cause - bricklaying Clue – spot the difference

12. Bricklaying Hazard Bricklaying Hazard – cement is hygroscopic Effect is excess dryness – usually short-lived if treated

13. Hazard Hazard – hexavalent chromium in cement Effect - allergic/contact dermatitis - sensitised for life

14. Work the cause Work the cause – needle gun operator Hazards and effects?

15. Hazards are high sound pressure levels and high levels of vibration.

16. Work the cause Work the cause – needle gun Effects – noise-induced hearing loss and Hand Arm Vibration Syndrome

17. Work the cause Work the cause – chrome plating - Hazard and effects?

18. Work the cause Work the cause – chrome plating Hazard is hexavalent chromium in mists

19. Work the cause Work the cause – chrome plating Effects – sensitisation, irritation, cutaneous ulcers, perforation of nasal septum (and lung cancer)

20. Work the cause of what disorders of the knee?

21. Categories of work-related diseases IWork the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

22. Work a causal factor in diseases of common occurrence ShipwrightShipwright TypistTypist Road construction workersRoad construction workers Soldier, sailor and airmanSoldier, sailor and airman Teachers, Prison Service, PoliceTeachers, Prison Service, Police Florist, hairdresserFlorist, hairdresser Vehicle sprayers, bakersVehicle sprayers, bakers FishmongerFishmonger

23. Categories of work-related diseases IWork the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

24. Welding fume and chronic obstructive pulmonary disease

25. Categories of work-related diseases IWork the cause II Work a causal factor in diseases of common occurrence III Work aggravating an established disease IV Work offering ready access to potential dangers

29. Learning points Range of adverse effects of workRange of adverse effects of work on individuals in common occupations on individuals in common occupations Importance of considering occupationImportance of considering occupation when seeking a diagnosis or a remedy when seeking a diagnosis or a remedy Readily accessible sources of information about occupational diseaseReadily accessible sources of information about occupational disease

30. Readily accessible sources of information about occupational disease First port of call : Health and Safety Executive: www.hse.gov.uk www.hse.gov.uk Government policy on health at work: www.dh.gov.uk www.dh.gov.uk

31. Is work making your patients ill? Part 2 Work and disease Grant McMillan Hon Senior Clinical Lecturer Thank you for your attention