Occupational Health Care

  • Greg Vanichkachorn
  • Judith McKenzie
  • Edward Emmett
Living reference work entry


The evaluation and management of work-related health conditions offers the family physician a unique medical challenge that may extend far beyond the confines of a clinic or a hospital. The floors of a lumber mill, the flight deck of a 747, and the dark tunnels of a coal mine are but a few of the environments that can become the concern of the family physician caring for the worker.

From Antiquity to Nanotechnology

The practice of occupational and environmental medicine has its roots in antiquity. Concern for the health of workers has been documented as early as ancient Egypt when Imhotep, considered the grandfather of occupational medicine, described treatment for injuries sustained by pyramid workers. Similar writings are found in ancient Greece, when both Hippocrates and Pliny the Elder wrote on the maladies of miners, horsemen, and metalworkers. Throughout history, many figures have advanced the health of workers. However, it is Bernardino Ramazzini that is considered...


Occupational Health Family Physician Occupational Medicine Injured Worker Occupational Injury 
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  1. 1.
    Arnold M, Lukcso D, Green-McKenzie J, Bender J, Rothstein M, Leone F et al. Occupational health services. New York: Routledge; 2012.Google Scholar
  2. 2.
    Gochfeld M. Chronologic history of occupational medicine. J Occup Environ Med. 2005;47:96–114.CrossRefPubMedGoogle Scholar
  3. 3. ABMS board certification report [Internet]. 2015 [cited 23 Apr 2015]. Available from:
  4. 4. Public comments | ACOEM comments on graduate medical education program [Internet]. 2015 [cited 14 Apr 2015]. Available from:
  5. 5. Employer-reported workplace injury and illness summary [Internet]. 2015 [cited 23 Apr 2015]. Available from:
  6. 6. Nonfatal occupational injuries and illnesses requiring days away from work, 2013 [Internet]. 2015 [cited 23 April 2015]. Available from:
  7. 7.
    Sengupta I, Baldwin M, Reno V. Workers’ compensation: benefits, coverage, and costs, 2012 [Internet]. Washington, DC: National Academy of Social Insurance; 2014. Available from:
  8. 8.
    Soni A. Trends in the five most costly conditions among the U.S. Civilian Noninstitutionalized Population, 2002 and 2012. Rockville: Agency for Healthcare Research and Quality; 2015.Google Scholar
  9. 9. Public Law 91-596 84 STAT. 1590 91st Congress, S.2193 December 29, 1970, as amended through January 1, 2004. (1) [Internet]. 2015 [cited 7 May 2015]. Available from:
  10. 10. CDC – about NIOSH [Internet]. 2015 [cited 25 Apr 2015]. Available from:
  11. 11. U.S. Department of Labor – Find it by topic – Disability resources – Americans with Disabilities Act [Internet]. 2015 [cited 26 Apr 2015]. Available from:
  12. 12. U.S. Department of Labor – Find it by topic – Leave benefits – FMLA [Internet]. 2015 [cited 11 Apr 2015]. Available from:
  13. 13.
    Vanichkachorn G, Roy B, Lopez R, Sturdevant R. The evaluation and management of the acutely injured worker. Am Fam Physician. 2014;1:17–24.Google Scholar
  14. 14.
    American College of Occupational Medicine. Occupational medicine practice guidelines, 3rd edn [Internet]. Available from:
  15. 15.
    (NCIPC) N, (DUIP) D, Prevention C. Understanding the epidemic | Prescription drug overdose | CDC Injury Center [Internet]. 2015 [cited 26 Apr 2015]. Available from:
  16. 16.
    Politi B, Arena V, Schwerha J, Sussman N. Occupational medical history taking: how are today’s physicians doing? A cross-sectional investigation of the frequency of occupational history taking by physicians in a major U.S. Teaching Center. J Occup Environ Med. 2004;46:550–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Cegolon L, Lange J, Mastrangelo G. The primary care practitioner and the diagnosis of occupational diseases. BMC Public Health. 2010;10:405.PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Chou R. Will this patient develop persistent disabling low back pain? JAMA. 2010;303:1295.CrossRefPubMedGoogle Scholar
  19. 19.
    Derebery J, Anderson J. Low back pain. 2nd ed. Beverly Farms: OEM Press; 2008.Google Scholar
  20. 20.
    Dasinger L, Krause N, Thompson P, Brand R, Rudolph L. Doctor proactive communication, return-to-work recommendation, and duration of disability after a workers’ Compensation low back injury. J Occup Environ Med. 2001;43:515–25.CrossRefPubMedGoogle Scholar
  21. 21.
    Besen E, Young A, Shaw W. Returning to work following low back pain: towards a model of individual psychosocial factors. J Occup Rehabil. 2014;25:25–37.PubMedCentralCrossRefGoogle Scholar
  22. 22.
    Kosny A, Franche R, Pole J, Krause N, Côté P, Mustard C. Early healthcare provider communication with patients and their workplace following a lost-time claim for an occupational musculoskeletal injury. J Occup Rehabil. 2006;16:25–37.CrossRefGoogle Scholar
  23. 23.
    Hegmann K, Weiss M, Bowden K, Branco F, DuBrueler K, Els C, et al. Opioids and safety-sensitive work. J Occup Environ Med. 2014;56:e134–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Webster B, Verma S, Gatchel R. Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use. Spine. 2007;32:2127–32.CrossRefPubMedGoogle Scholar
  25. 25.
    Mustard C, Bielecky A, Etches J, Wilkins R, Tjepkema M, Amick B, et al. Mortality following unemployment in Canada, 1991–2001. BMC Public Health. 2013;13:441.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Preventing needless work disability by helping people stay employed. J Occup Environ Med. 2006;48:972–87. Available from:
  27. 27.
    Talmage J, Melhorn J. A physician’s guide to return to work. 2nd ed. Chicago: AMA Press; 2011.Google Scholar
  28. 28. Position statements | The personal physicians role in helping patients with medical conditions stay at work or return to work [Internet]. 2015 [cited 28 Apr 2015]. Available from:
  29. 29.
    Won J. Services provided by family physicians for patients with occupational injuries and illnesses. Ann Fam Med. 2006;4:138–47.PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Marras W, Ferguson S, Lavender S, Splittstoesser R, Yang G. Cumulative spine loading and clinically meaningful declines in low-back function. Human Factors J Hum Factors Ergon Soc. 2013;56:29–43.CrossRefGoogle Scholar
  31. 31.
    Sterud T, Tynes T. Work-related psychosocial and mechanical risk factors for low back pain: a 3-year follow-up study of the general working population in Norway. Occup Environ Med. 2013;70:296–302.CrossRefPubMedGoogle Scholar
  32. 32. [Internet]. 2015 [cited 1 May 2015]. Available from:
  33. 33.
    Shiri R, Miranda H, Heliovaara M, Viikari-Juntura E. Physical work load factors and carpal tunnel syndrome: a population-based study. Occup Environ Med. 2009;66:368–73.CrossRefPubMedGoogle Scholar
  34. 34.
    Harris-Adamson C, Eisen E, Kapellusch J, Garg A, Hegmann K, Thiese M, et al. Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers. Occup Environ Med. 2014;72:33–41.PubMedCentralCrossRefPubMedGoogle Scholar
  35. 35.
    Silverstein B, Bao S, Fan Z, Howard N, Smith C, Spielholz P, et al. Rotator cuff syndrome: personal, work-related psychosocial and physical load factors. J Occup Environ Med. 2008;50:1062–76.CrossRefPubMedGoogle Scholar
  36. 36. CDC – NIOSH publications and products – preventing slips, trips, and falls in wholesale and retail trade establishments (2013-100) [Internet]. 2015 [cited 28 Apr 2015]. Available from:
  37. 37.
    Centers for Disease Control and Prevention. Summary report for blood and body fluid exposure data collected from participating healthcare facilities [Internet]. 2007. Available from:
  38. 38.
    LaDou J. Current occupational & environmental medicine. 5th ed. New York: McGraw-Hill; 2014.Google Scholar
  39. 39.
    Prevention C. Centers for Disease Control and Prevention [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  40. 40. Chemical data reporting (CDR) | US Environmental Protection Agency [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  41. 41. Occupational Safety and Health Administration – Home [Internet]. 2015 [cited 12 Apr 2015]. Available from:
  42. 42. US Environmental Protection Agency [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  43. 43. Safety and health topics | Latex allergy [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  44. 44.
    [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  45. 45.
    Hardin BD, Kelman BJ, Saxon A. Adverse human health effects associated with molds in the indoor environment. J Occup Environ Med. 2003;45:470–8.Google Scholar
  46. 46.
    Sauni R, Verbeek J, Utti J, Jauhiainen M, Kreiss K, Sigsgaard T. Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma. Evidence-Based Child Health Cochrane Rev J. 2015. Available from:
  47. 47. Census of fatal occupational injuries summary, 2013 [Internet]. 2015 [cited 30 Apr 2015]. Available from:
  48. 48. Home [Internet]. 2015 [cited 30 Apr 2015]. Available from:

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Greg Vanichkachorn
    • 1
  • Judith McKenzie
    • 2
  • Edward Emmett
    • 3
  1. 1.Occupational Health ServicesKalispell Regional HealthcareKalispellUSA
  2. 2.Division of Occupational Medicine, Department of Emergency MedicinePerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  3. 3.Center for Excellence in Environmental ToxicologyPerelman School of MedicinePhiladelphiaUSA

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