Advanced organizer Chapter 2

Starting from the disease : a latex allergy problem in a health care worker a five-step procedure: (1) disease; (2) exposure; (3) other possible causes; (4) judgment as to the disease is work related or not; (5) intervention. A 32-year-old female is referred to the clinic by the occupational physicianbecause of a recent onset of rhinitis and wheezing. Her occupational history was that she had worked as a nurse in the emergency department for7 years and in an internal ward for 3 years. Her medical history included a food allergy (kiwis, nuts, bananas, tomatoes, among others) and aCaesarean 4 years ago and during surgery she had an anaphylactic reaction (severe hypotension and tachycardia). When she returned to work after pregnancy leave, shereacted with itching bumpson her hands, minutes after putting on latex gloves. She noticed that her condition improved significantly when she was on her days off. Latex-specific IgEtesting and skin prick testing confirmed the suspicion of latex allergy. As important preventive measure she was advised to no longer use latex gloves. She was able to continue her work as a nurse until aweek ago.During a work activity involving frequent gloves change, she started to have nasal symptoms and shortness of breath. Her colleague was wearing latex gloves. How would you further diagnose and treat this nurse? We can refer the students to USA based Hospital eTool : do we have an European alternative? Use the Hospital eTool : this website focuses on the risks in a hospital setting for various health care workers. It contains graphical menus and expert system modules that enable the user to answer questions, and receive advice on OSHA regulations. The additional information starts with a picture of a hospital where you can click on 15 different departments. Legislation is USA based. http://www.osha.gov/SLTC/etools/hospital/index.html http://www.osha.gov/SLTC/etools/hospital/hazards/latex/latex.html

Starting from the exposure : the garage a four-step procedure: (1) hazards; (2) exposure assessment; (3) characterize the risk; (4) management of risk (collective and individual). We can make an own movie, inspired by the Dutch Labour Inspection!!! They realized a short video with dangerous situations for young auto-mechanics. We can do the same for occupational hazards and exposures. Go to the following url (in Dutch) : http://zelfinspectie.nl/garage/

You click on >verder ; on the second slide you click on the clothes of the man (wear appropriate clothes is the message!). Continue >naar de garage and you have a walk-through the garage. You can click on things you observe. There are 10 dangerous items and you get feedback and tips if you dont find the answers.