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Philip J. Landrigan, MD, MSc; Dean B. Baker, MD, MPH

JAMA. 1991;266(5):676-680.

Abstract
Occupational diseases account each year in the United States for an estimated 50 000 to 70 000 deaths and 350 000 new cases of illness. Often, however, occupational diseases are not correctly diagnosed, because they mimic diseases due to other causes and because most physicians are not well trained in their recognition. Opportunities for prevention and treatment are therefore lost. The occupational history is the most effective means for proper diagnosis of occupational illness. It should routinely be obtained for every patient. A brief but systematic guide for obtaining an occupational history is presented in this report. Also, approaches are summarized for the recognition and diagnosis of such important occupational diseases as occupational cancer, asbestosis and other respiratory disorders, and occupational neuropsychologic disorders. The management and prevention of occupational diseases depend on reduction of hazardous exposures in the workplace and better education of workers, industrial managers, and physicians. This report outlines a program for the control of occupational disease based on (1) preventing exposures in the workplace, (2) premarket toxicity testing of new chemicals and technologies, and (3) astute clinical diagnosis.

(JAMA. 1991;266:676-680)

Author Affiliations
From the Department of Community Medicine, Mount Sinai School of Medicine, New York, NY.

Footnotes
Reprint requests to Department of Community Medicine, Box 1057, Mount Sinai Medical Center, One Gustave L Levy Pl, New York, NY 10029 (Dr Landrigan).

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