Preface

The Fifth Edition of Current Occupational & Environmental Medicine continues to serve as a concise yet comprehensive resource for health care professionals in all specialties who diagnose and treat occupational and environmental injuries and illnesses.

The book provides a complete guide to common occupational and environmental injuries and illnesses, their diagnosis and treatment, and preventive measures in the workplace and community. Our aim is to help health care professionals understand the complexities of occupational and environmental health issues and provide useful clinical information on common illnesses and injuries. The book contains many new chapters, expanding the coverage of occupational and environmental medicine well beyond that of the earlier editions. To enhance the book's usefulness as a clinical resource, it is published in the Lange¯ Current series. The series consists of practical, concise, and timely books in core specialties and key subspecialties that focus on essential diagnostic and treatment information.

• Detailed coverage on the diagnosis and treatment of a broad spectrum of occupational and environmental injuries and illnesses.

• Chapters on how to conduct an occupational and environmental history, perform a physical examination, and prevent further injury.

• The important role that health care providers can play in preventing disability.

• Practical information on the toxic properties and clinical manifestations of common industrial materials.

• Techniques to prevent workplace-related injuries and illnesses through the application of ergonomic principle.

Section I (Chapters 1, 2, 3, 4, 5, 6, and 7) define the practice of occupational and environmental medicine and introduce the health care provider to the diagnosis of occupational injuries and illnesses. These chapters offer guidance for identifying workplace and community exposures to toxic materials—putting this information to immediate clinical use and applying it toward better health and safety practices in the workplace. This section presents a comprehensive discussion of disability prevention and management, and considers the important issues in the international practice of occupational and environmental medicine.

Section II (Chapters 8, 9, 10, 11, 12, 13, 14, and 15) concisely discusses common occupational injuries and their treatments. Noise-induced hearing loss and the impact of other physical hazards, such as heat, cold, and radiation are examined. This section also discusses how ergonomic principles can be instituted in the workplace to prevent further work loss associated with injury and illness. The chapter on management of chronic pain is an important new addition to the book.

Section III (Chapters 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, and 29) is a comprehensive discussion of clinical toxicology arranged by organ system, with special emphasis on the environmental as well as workplace origins of toxic exposure. It thoroughly reviews commonly recognized environmental and occupational illnesses and highlights many clinical problems not often thought to be work related.

Section IV (Chapters 30, 31, 32, 33, and 34) presents the most common toxic materials encountered in the workplace and community with diagnostic and treatment recommendations. This section is designed to serve as an immediate reference source and clinical guide for the practicing health care professional. The discussion on pesticides, in particular, emphasizes the environmental as well as occupational exposures that may lead to illness.

Section V (Chapters 35, 36, 37, 38, 39, 40, 41, and 42) presents the roles and responsibilities of the industrial hygienist and the safety professional. Chapters on occupational mental health and workplace violence, and substance use disorders present programs for controlling and treating these problems.

Section VI (Chapters 43, 44, 45, 46, 47, 48, 49, and 50) provides a comprehensive discussion of environmental medicine and some of the complex societal issues that accompany industrialization and technologic advances throughout the world. Emphasis is placed on recognizing that some common "occupational" exposures are found also in homes and public locations and require the same high index of suspicion that is assumed when encountered in the workplace.

The Appendix concisely introduces biostatistics and epidemiology. These topics are important not only in research but also in clinical practice. Ultimately, all occupational and environmental physicians serve as clinical epidemiologists.

This book brings together UCSF faculty with a combined experience of 40 years of teaching occupational and environmental medicine, and many graduates of the program now working in public health agencies and other campuses. I also welcome the new co-editor, Robert J. Harrison, MD, MPH, whose considerable contributions to the former editions of the book uniquely qualify him to take on this role.