by Ada Kahn, PhD

Injuries are a ubiquitous phenomenon in almost every work environment. When the field of industrial medicine began, the primary concern was to provide first aid after an accident, such as physical trauma or chemical body injury, and to diagnose occupational diseases, such as skin allergies, contact dermatitis, occupational asthma or pneumoconiosis.

Today, industrial medicine encompasses a wide range of multidisciplinary specialists ranging from orthopedists who treat back injuries of construction workers and plastic surgeons who treat burn injuries, to psychiatrists who treat people dealing with mental health issues resulting from the stress of a bullying supervisor or a passive-aggressive coworker. In addition, the field has gained the attention of epidemiologists and researchers interested in occupational-related allergies, toxic substances, mineral fibers, cancer, inhalation lung diseases, ergonomics, continual use of computer screens, and repetitive stress issues, just to name a few.

The Journal of the American Medical Association reports that 3.6 million Americans were treated at hospital emergency rooms for occupational injuries or illnesses in 1998. This translates to an overall occupational injury and illness rate of 2.9 per 100 full-time employees over age 15. Injury rates were highest in men and younger workers.

OSHA reported that in 2000, occupational injury and illness rates dropped to their lowest level, 6.1 injuries per 200 workers, reflecting an eight-year downward trend since the U.S. began collecting this information.

Although we may think of external impact on the human body as a workplace injury, many injuries are more subtle. I remember diagnosing a patient with ulnar neuropathy three months after she had been issued an expensive ergonomic chair with armrests. I suggested she either get rid of the chair or at least remove the armrests. Within two months after removing the armrests, the ulnar neuropathy resolved. Physicians treat many work-related injuries that don’t warrant loss of work. Consequently, there may be considerably more work-related injuries than the statistic would reflect.

Health Maintenance Organizations (HMOs) and their Managed Care Organizations (MCOs) may have further skewed the data. Physicians who are being forced to make decisions more rapidly will not be able to explore the possible causes of an illness. Empirical treatment will be less focused and thus less effective. Minor injuries that normally would not require time away from work would progress into something major and disabling.

A medical interview can reveal the true source of an injury. For example, a patient who attributes back pain to the work environment may come to realize that it occurred on the weekend while doing yard work or lifting heavy furniture or moving an aquarium. These correlations take time. A physician, complying with the HMO or MCO, is expected to see a patient every 12 or 15 minutes and may be unable to evaluate the exact causation. Lack of interview and examination time could falsely inflate the number of workplace injuries.

A worker’s lifestyle can make it difficult to correlate an illness to the work environment. A smoker with asbestosis will be more likely to develop lung cancer than either a smoker without asbestosis or a nonsmoker with asbestosis. It becomes difficult, however, to say that a smoker has developed lung cancer due to industrial asbestos exposure. This is the assessment that most worker compensation evaluations must address.

It is the responsibility of the working people of America to understand safety and health issues related to their work environment and to take the appropriate precautions. They should also understand their health and safety rights. Workers do have the right to refuse a job if they think it will create a potentially unsafe workplace condition. If they are discriminated against for refusing, they can report this to the Occupational Safety & Health Administration (OSHA) of the U.S. Department of Labor. Many laws, including the OSHA Act of 1970 and the Asbestos Hazard Emergency Response Act, have whistleblower protections.

Ada P. Kahn makes an excellent selection of the injuries and illnesses that occur in the workplace. She covers a wide variety of occupations and outlines the hazards and injuries unique to those occupations. Psychosocial issues such as burnout, bullying and stress, also important for a worker’s well being, are addressed. Kahn interconnects the stress of one worker to the diagnosis of a fellow worker. For instance, an AIDS patient in the workplace is not considered infectious. However, there may be insurmountable anxiety or panic attacks in coworkers if they become aware of that diagnosis. These contemporary issues are alphabetically tabulated for easy reference in this readable, user-friendly compendium of 600 entries in 220,000 words. It contains many entries of conditions that physicians see every day, including physical and emotional disorders. Preventive measures are also included in some instances.

This book is not intended to provide complete information on any one topic. Instead, this reference is designed for individuals who want an overview of work-related issues. Kahn’s earlier books for Facts on File, Inc: The Encyclopedia of Mental Health, The Encyclopedia of Phobias, Fears and Anxieties, and Stress A-Z, were written for the lay reader but have become desk references for many professionals. The Encyclopedia of Work-Related Injuries, Illnesses and Health Issues will also be an important volume for professionals in many fields, including health care, human resources, employee benefits, insurance carriers, employee assistance programs, librarians and others. It gives the type of information employers and employees frequently need.

Dr Kahn’s books can be purchased at http://www.factsonfile.com/. Enter Kahn in the search box.