Chapter

Respiratory disorders

Keith T. Palmer and Paul Cullinan

in Fitness for Work

Fifth edition

Published on behalf of Oxford University Press

Published in print January 2013 | ISBN: 9780199643240
Published online April 2013 | e-ISBN: 9780191755668 | DOI: http://dx.doi.org/10.1093/med/9780199643240.003.0018

Series: Landmark Papers

Respiratory disorders

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  • Occupational Medicine
  • Public Health and Epidemiology
  • Occupational Therapy
  • Respiratory Medicine and Pulmonology

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Respiratory illnesses commonly cause sickness absence, unemployment, medical attendance, illness, and handicap.1 Collectively these disorders cause 19 million days/year of certified sickness absence in men and 9 million days/year in women (with substantial additional lost time from self-certified illness) and, among adults of working age, a general practitioner consultation rate of 48.5 per 100/year with more than 240 000 hospital admissions/year. Prescriptions for bronchodilator inhalers run at some 24 million/year, and mortality from respiratory disease causes an estimated loss of 164 000 working years by age 64 and an estimated annual production loss of £1.6 billion (at prices in 2000). Respiratory disease may be caused, and pre-existing disease may be exacerbated, by the occupational environment. More commonly, respiratory disease limits work capacity and the ability to undertake particular duties. Finally, individual respiratory fitness in ‘safety critical’ jobs can have implications for work colleagues and the public. Within this broad picture, different clinical illnesses pose different problems. For example, acute respiratory illness commonly causes short-term sickness absence, whereas chronic respiratory disease has a greater impact on long-term absence and work limitation; and the fitness implications of respiratory sensitization at work are very different from non-specific asthma aggravated by workplace irritants. Occupational causes of respiratory disease represent a small proportion of the burden, except in some specialized work settings where particular exposures give rise to particular disease excesses. The corollary is that the common fitness decisions on placement, return to work, and rehabilitation more often involve non-occupational illnesses than occupational ones. By contrast, statutory programmes of health surveillance focus on specific occupational risks (e.g. baking) and specific occupational health outcomes (e.g. occupational asthma). In assessing the individual it is important to remember that respiratory problems are often aggravated by other illnesses, particularly disorders of the cardiovascular and musculoskeletal systems.

Chapter.  13315 words.  Illustrated.

Subjects: Occupational Medicine ; Public Health and Epidemiology ; Occupational Therapy ; Respiratory Medicine and Pulmonology

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