Education And Debate


BMJ 1996; 313 doi: (Published 31 August 1996) Cite this as: BMJ 1996;313:551
  1. David Snashall

    Specific infections due to work are not common, but some systemic ones are serious and easy to miss unless there is a high index of suspicion. Carefully taking a patient's occupational history may reveal the diagnosis for an unusual illness. Superficial infections are less serious but may be difficult to diagnose and treat and can be transmitted to others. Some infections may cause an allergic response (such as farmer's lung), and endotoxins and mycotoxins can cause acute and chronic respiratory symptoms (such as mycobyssinosis in cotton workers). Like all occupational diseases, occupational infections are mostly preventable.

    Occupational groups at risk of infections contracted at work

    • Veterinary surgeons—leptospirosis, Q fever

    • Farm workers—ringworm, leptospirosis, orf, tetanus, perhaps bovine spongiform encephalopathy

    • Poultry workers—ornithosis, histoplasmosis, Newcastle disease

    • Health workers—hepatitis, HIV

    • Construction workers—tetanus

    • Butchers and abattoir workers—Streptococcus suis, Q fever

    • Forestry workers—Lyme disease

    • Engineering workers—skin infection

    • Overseas workers returning home—tropical diseases, brucellosis, anthrax

    Some infections are included in the list of diseases prescribed under the Industrial Injuries Provisions of the Social Security Act 1975. The affected person can claim “no fault” compensation from the government if the “prescribed” disease is considered to be the result of certain kinds of work and if disability is rated at over 14%.

    There is a similar list of “reportable” diseases, some of them infectious, caused by work, and it is the duty of the employer (often advised by the doctor who diagnoses the disease) to report them under the RIDDOR regulations to the Health and Safety Executive or, sometimes, to the local environmental health department. They used to be called “notifiable” occupational diseases. The name changed in 1980, and they should be distinguished from those infectious diseases that are notifiable under the Public Health Acts. Later this year CCDCs will start reporting occupational infections, publishing the numbers quarterly.

    Employers are also bound to comply with the COSHH regulations …

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