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Home Page for Health, Environment & Work Problem based tasks for learning

Occupational & Environmental Medicine

These are designed to help you achieve important learning objectives in Occupational and Environmental Medicine. You should attempt these on your own, or with a colleague. Some of the tasks may be tackled in small group teaching. Your teachers will advise.


Consider a specific adult patient you have seen in general medical practice or in hospital, and who is suffering from a disease such as asthma, dermatitis, or back pain. Take a careful occupational history as well as a history of other relevant exposures: DIY, leisure etc. 

Is it possible that some of these exposures could be contributing to the ill-health, by causing it, or by aggravating it? 

If this is a possibility, consider the answers to the following questions: 

  • To what hazards is the patient exposed? (You may wish to consult some guidance regarding the influence of Work on Health
  • How can you determine the extent of exposure to the hazards?
  • Therefore what is the patient's 'a priori' risk of work-related ill-health?
  • How may the patient's symptoms and signs relate to the occupational risks in terms of ...timing? ...severity? ...biological plausibility? ...consistency with other observations? (Remember the epidemiologic criteria for causal association, and consider the clinical analogies)
  • What steps would you consider to protect the patient, by reducing exposure ... at source? or... through personal protection? or in other ways?
  • Who would you liase with, to achieve these aims?
  • What about the risks to other workers: How would one determine the frequency of similar ill-health amongst fellow workers? ... How would one find out who was at risk?... What steps should be taken to protect them?


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