Intended for healthcare professionals

Education And Debate


BMJ 1996; 313 doi: (Published 28 September 1996) Cite this as: BMJ 1996;313:809
  1. Keith Palmer,
  2. David Coggon

    Doctors working in general practice or hospital sometimes encounter patients whom they suspect may have an occupational disease (for example, work related asthma, dermatitis, or fibrotic lung disease). It is important to follow up such suspicions because they may present opportunities for preventing disease or for compensation. Several sources of advice are available, but before others are consulted it is important to obtain the patient's consent, particularly if personal information is to be disclosed. Discussion with the patient is also recommended if any approach is to be made to the employer.

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    Conditions that are commonly occupational

    If the patient's employer has an occupational health department the doctor or nurse there can be consulted in confidence. Occupational health staff are bound by the same duties of confidentiality as other health professionals and have special knowledge of the workplace and its hazards. If the company does not have an occupational health service, help can be obtained from the Health and Safety Executive. Their doctors, nurses, and inspectors have a statutory right of entry to all workplaces and respect requests for anonymity (though employers may ultimately suspect the source of a complaint).

    Sources of advice for doctors not working in industry

    • Occupational health department at patient's workplace—Many larger employers have their own occupational physicians, who can be approached in confidence

    • Health and Safety Executive (HSE)—Telephone number and address of your local regional office should be listed in telephone directory under “Health and Safety Executive.” Inquiries may be directed either to the Employment Medical Advisory Service (medical arm of HSE) or the inspectorate

    • Academic departments of occupational medicine—Some centres provide clinics to which doctors can refer patients

    • NHS consultant occupational physicians—Growing numbers of NHS trusts employ consultant occupational physicians, who are willing to provide informal advice to colleagues on occupational health problems. A few offer clinics to which patients can be referred

    Occupational clusters of disease

    One …

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