DOCSLIB.ORG

Guidelines for Occupational Medical Examinations

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Guidelines for Occupational Medical Examinations Guidelines for Occupational Medical Examinations PROPHYLAXIS IN OCCUPATIONAL MEDICINE Gentner Verlag Guidelines for Occupational Medical Examinations Gentner Verlag Guidelines for Occupational Medical Examinations Impressum Publisher: Deutsche Gesetzliche Unfallversicherung DGUV (German Social Accident Insurance) Editor: Priv.-Doz. Dr. Jürgen J. Milde, Ausschuss Arbeitsmedizin (Committee for occupational medicine of the DGUV) Translator: Dr. Ann E. Wild Copy-Deadline: September 2007 Deutsche Bibliothek Cataloguing in Publication Data see: http://dnb.ddb.de ISBN 978-3-87247-691-3 © 2007 Gentner Verlag, Stuttgart, Germany Cover: GreenTomato GmbH, Bielefeld/Stuttgart Production: Druckerei Marquart GmbH, Aulendorf Printed in Germany All rights reserved Contents Contents Preface 7 1 Introduction: Guidelines for occupational 9 medical examinations 1.1 Occupational medical care 11 1.2 Risk assessment and health surveillance 11 1.2.1 Responsibilities of the occupational health professional 12 1.3 Guidelines for occupational medical examinations 13 1.3.1 Which Guidelines exist? 15 1.3.2 Browsing the Guidelines 17 1.4 Supplementary notes 22 2 Guidelines for occupational medical examinations 25 G 1.1 Mineral Dust, Part 1: Respirable crystalline silica dust 27 G 1.2 Mineral Dust, Part 2: Dust containing asbestos fibres 37 G 1.3 Mineral Dust, Part 3: Man-made mineral fibres 47 (aluminium silicate wool) G 1.4 Exposure to dust 55 G 2 Lead and lead compounds 65 (with the exception of alkyllead compounds) G 3 Alkyllead compounds 75 G 4 Substances which cause skin cancer or skin alterations 83 which tend to become cancerous G 5 Ethylene glycol dinitrate and glycerol trinitrate 91 (glycol dinitrate and nitroglycerin) G 6 Carbon disulfide 99 G 7 Carbon monoxide 109 G 8 Benzene 117 G 9 Mercury and mercury compounds 125 G 10 Methanol 135 G 11 Hydrogen sulfide 143 G 12 Phosphorus (white, yellow) 151 G 14 Trichloroethene (trichloroethylene) 159 and other chlorinated hydrocarbon solvents G 15 Chromium(VI) compounds 173 Guidelines for Occupational Medical Examinations G 16 Arsenic and arsenic compounds (with the exception of arsine) 183 G 19 Dimethylformamide 193 G 20 Noise 201 G 21 Cold working conditions 223 G 23 Obstructive airway disorders 229 G 24 Skin disorders (not including skin cancer) 239 G 25 Driving, controlling and monitoring work 247 G 26 Respiratory protective equipment 257 G 27 Isocyanates 267 G 29 Benzene homologues (toluene, xylene isomers) 279 G 30 Hot working conditions 287 G 31 Hyperbaric pressure 295 G 32 Cadmium and cadmium compounds 305 G 33 Aromatic nitro and amino compounds 313 G 34 Fluorine and its inorganic compounds 325 G 35 Work abroad under exceptional climatic conditions 335 and with other health risks G 36 Vinyl chloride 343 G 37 VDU (visual display unit) workplaces 351 G 38 Nickel and nickel compounds 363 G 39 Welding fumes 373 G 41 Work involving a danger of falling 387 G 42 Activities with a risk of infection 393 G 44 Hardwood dust 537 G 45 Styrene 545 G 46 Strain on the musculoskeletal system (including vibration) 557 3 Appendices 577 A 1 Biomonitoring 579 A 2 Diagnosis of musculoskeletal disorders in occupational 593 medical examinations Preface 7 Preface In its Centennial Declaration in Milan on the 11th of June 2006 the International Commission on Occupational Health, ICOH, called for the following global actions: “provision of competent occupational health services for every working individual and every workplace in the world, ensuring services for prevention and protection as well as competent diagnosis and recognition …”. The present standard work on occupational medicine makes a contribution to this global target of the ICOH. It describes the fundamentals of quality-controlled occu- pational medical prophylaxis, which are in line with the stipulations for health sur- veillance found in the European Council Directive for improving the safety and health of workers at work. In some European countries the Guidelines for occupational medical examinations are already known as established procedures for the medical care of persons ex- posed to certain specific work-related health risks, especially hazardous substances, noise, airway disorders, risk of infection, skin disorders, but also work at VDU work- places and work involving strain on the musculoskeletal system. For decades, specialists in occupational medicine have been working on the basis of these guidelines which are generally accepted to provide a good basis for qualita- tively consistent procedures in occupational medical prophylaxis. The Guidelines are elaborated, kept up to date and further developed by teams of experts from all rel- evant fields under the auspices of the German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung, DGUV). The Guidelines recommend methods of ex- amination to be used and apparatus required, they include information about expo- sures, symptoms and syndromes, and give the physician support in advising the pa- tient and assessing the examination results. This standard work on occupational medicine is organized according to a universal concept and the resulting clear structure makes it easy to use in occupational medical practice. The German Social Accident Insurance, DGUV, which since its institution in 1884 has committed itself not only to compensation but also to the prevention of workplace accidents and occupational disease and to the rehabilitation of em- ployees, welcomes suggestions and comments for the improvement of the Guidelines. Sankt Augustin, September 2007 Deutsche Gesetzliche Unfallversicherung Introduction: Guidelines for occupational 1 medical examinations Introduction: Guidelines for occupational medical examinations 11 1 Introduction: Guidelines for occupational medical examinations J. J. Milde, German Social Accident Insurance (DGUV), Sankt Augustin 1.1 Occupational medical care Globalization and the increase in competition resulting from international trading have led to increasing expectations of workforce productivity in enterprises every- where in Europe. In addition, demographic developments are increasing the aver- age age of workers (the ageing workforce). The economic success of an enterprise depends on the abilities of well-trained and experienced employees. Thus, the main- tenance and promotion of health of employees is becoming increasingly important from both the social and economic points of view, to do justice to the demands of so- ciety for appropriate quality of work and also to provide a basis for economic suc- cess. A healthier work environment does not only provide competitive advantages, it becomes an indicator of the social acceptability of successful commerce. In the European Union, employers are required as part of their statutory “duty of care” to provide adequately for the health and safety of their employees. Although there are considerable differences between the relevant regulations in the various member states of the EU, there is a common basis which is described in the Council Directive 89/391/EEC and the associated individual directives. Occupational med- ical care, which is concerned with the interaction between work, profession and health, is covered by these directives. Its particular aims include: • assessment of working conditions (risk assessment) • provision of recommendations for improvement of working conditions • informing and advising the employees about work-related risks • early recognition and prevention of occupational diseases and work-related ill- nesses • improving our knowledge of exposures and risks. Thus occupational medical care does not only aim to keep employees healthy but also to bring about improvements in health protection at the workplace. By means of occupational medical care, the employer can demonstrate that he is meeting his “duty of care” responsibilities, provided that the medical care is provided by quali- fied specialists under quality-controlled conditions and the results are appropriately documented. 1.2 Risk assessment and health surveillance Fundamental to health and safety protection at the workplace is the risk assessment. For this purpose the employer assesses (before a person starts work and at certain 12 Guidelines for Occupational Medical Examinations intervals afterwards) whether and to what extent health and safety hazards for the employee are associated with the work. In this process he can use the support of health and safety experts and the works physician or an occupational health profes- sional. In principle, the employer is required to reduce any risks to a minimum and to institute any necessary general and individual protective measures. The risk assess- ment must be appropriately documented. If the results of the risk assessment suggest that in spite of all protective measures a significant risk for the health of an employee remains, occupational medical exami- nations carried out by a doctor or an appropriately qualified person should be con- sidered. The conditions under which occupational medical examinations are re- quired before an employee may begin or continue a job are stipulated by law. These examinations are therefore quite different from health check-ups or general exami- nations to establish whether a person is fit for work, which are not regulated by law nor associated with specific workplace exposures. Nonetheless, such medical exami- nations can also be a starting point for a general improvement of the health of a workforce and the maintenance of fitness for work; they are not the
Load more

Recommended publications
  • OCCUPATIONAL MEDICINE PROGRAM HANDBOOK October 2005
    U.S. DEPARTMENT OF THE INTERIOR OFFICE OF OCCUPATIONAL HEALTH AND SAFETY OCCUPATIONAL MEDICINE PROGRAM HANDBOOK October 2005 This Occupational Medicine Program Handbook was prepared by the U.S. Department of the Interior’s Office of Occupational Health and Safety, in consultation with the U.S. Office of Personnel Management and the U.S. Public Health Service’s Federal Occupational Health service. This edition of the Handbook represents the continuing efforts of the contributing agencies to improve occupational health services for DOI employees. It reflects the comments and suggestions offered by users over the years since it was first introduced, and addresses the findings, concerns, and recommendations summarized in the final report of a program review completed in 1994 by representatives of the Uniformed Services University of the Health Sciences. That report, entitled “A Review of the Occupational Health Program of the United States Department of the Interior,” was prepared by Margaret A.K. Ryan, M.D., M.P.H., Gail Gullickson, M.D., M.P.H., W. Garry Rudolph, M.D., M.P.H., and Elizabeth Odell. The report led to the establishment of the Department’s Occupational Health Reinvention Working Group, composed of representatives from the DOI bureaus and operating divisions. The recommendations from the Reinvention Working Group final report, published in May of 1996, were addressed and are reflected in what became this Handbook. First published in 1997, the Handbook underwent a major update in July, 2000. This 2005 version of the Handbook incorporates the updates and enhancements that have been made in DOI policies and occupational medicine practice since the last edition.
    [Show full text]
  • ZYGMO] (Kimura 2 Parameter, COI-5P, Length > 550)
    Supplement 2. BOLD TaxonID Tree: DNA barcoding of Zygaenidae moths [ZYGMO] (Kimura 2 Parameter, COI-5P, Length > 550). 2 % Sthenoprocris brondeli|Female|Madagascar Harrisina coracina|Male|Mexico.Veracruz Harrisina metallica|Female|United States.New Mexico Harrisina metallica|Male|United States.California Harrisina metallica|Male|United States.Arizona Harrisina metallica|Male|United States.California Harrisina metallica|Male|United States.Arizona Harrisina metallica|Male|United States.Arizona Harrisina metallica|Male|United States.Arizona Harrisina metallica|Male|United States.Arizona Astyloneura assimilis|Female|Democratic Republic of the Congo Astyloneura sp.|Male|Burundi Syringura triplex|Male|Cameroon Saliunca orphnina|Male|Rwanda Saliunca orphnina|Female|Rwanda Saliunca styx|Female|Democratic Republic of the Congo.Bas-Congo Saliunca styx|Female|Kenya Saliunca styx|Male|Kenya Saliunca styx|Male|Cameroon Saliunca styx|Male|Cameroon Saliunca meruana|Male|Tanzania Tascia finalis|Female|Zimbabwe Aethioprocris togoensis|Male|Ghana.Central Chalconycles sp. 01|Female|Africa Onceropyga anelia|Female|Australia.Queensland Onceropyga anelia|Male|Australia.Queensland Onceropyga anelia|Female|Australia.Queensland Onceropyga anelia|Female|Australia.Queensland Pseudoamuria neglecta|Female|Australia.Queensland Pseudoprocris dolosa|Female|Guatemala.Chimaltenango Pseudoprocris dolosa|Male|Guatemala.Chimaltenango Pseudoprocris gracilis|Male|Guatemala.Chimaltenango Corma maculata|Male|Myanmar.Sagaing Corma maculata|Male|Myanmar.Sagaing Cyclosia panthona|Male|Thailand.Sakon Nakhon Cyclosia panthona|Male|Thailand.Sakon Nakhon Cyclosia panthona|Female|Myanmar.Sagaing Cyclosia panthona|Female|China.Yunnan Cyclosia papilionaris|Female|Myanmar.Sagaing Cyclosia papilionaris|Male|Thailand.Sakon Nakhon Cyclosia papilionaris|Female|Myanmar.Sagaing Cyclosia papilionaris|Female|Myanmar.Sagaing Cyclosia papilionaris|Female|Myanmar.Sagaing Artona sp. 1|Male|Thailand.Chiang Mai Artona sp. 1|Female|Thailand.Chiang Mai Alteramenelikia sp. 1|Female|Ghana.Greater Accra Alteramenelikia sp.
    [Show full text]
  • A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment Among Healthcare Workers During the COVID-19 Pandemic in Italy †
    International Journal of Environmental Research and Public Health Article A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy † Alessandro Messeri 1,2,* , Michela Bonafede 3 , Emma Pietrafesa 3, Iole Pinto 4, Francesca de’Donato 5, Alfonso Crisci 1, Jason Kai Wei Lee 6,7,8,9,10,11 , Alessandro Marinaccio 3 , Miriam Levi 12 , Marco Morabito 1,2 and on behalf of the WORKLIMATE Collaborative Group ‡ 1 Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy; [email protected] (A.C.); [email protected] (M.M.) 2 Centre of Bioclimatology, University of Florence (UNIFI), 50144 Florence, Italy 3 Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; [email protected] (M.B.); [email protected] (E.P.); [email protected] (A.M.) 4 Physical Agents Sector, Regional Public Health Laboratory, 53100 Siena, Italy; [email protected] 5 Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy; [email protected] 6 Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; [email protected] 7 Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Citation: Messeri, A.; Bonafede, M.; Singapore S117593, Singapore 8 Pietrafesa, E.; Pinto, I.; de’Donato, F.; Global Asia Institute, National University of Singapore, Singapore S119076, Singapore 9 Crisci, A.; Lee, J.K.W.; Marinaccio, A.; N.1 Institute for Health, National University of Singapore, Singapore S117456, Singapore 10 Institute for Digital Medicine, National University of Singapore, Singapore S117456, Singapore Levi, M.; Morabito, M.
    [Show full text]
  • Rational Use of Personal Protective Equipment for Coronavirus Disease (COVID-19) and Considerations During Severe Shortages Interim Guidance 6 April 2020
    Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages Interim guidance 6 April 2020 Background • avoiding touching your eyes, nose, and mouth; • practicing respiratory hygiene by coughing or This document summarizes WHO’s recommendations for the sneezing into a bent elbow or tissue and then rational use of personal protective equipment (PPE) in health immediately disposing of the tissue; care and home care settings, as well as during the handling of • wearing a medical mask if you have respiratory cargo; it also assesses the current disruption of the global symptoms and performing hand hygiene after supply chain and considerations for decision making during disposing of the mask; severe shortages of PPE. • routine cleaning and disinfection of environmental and other frequently touched surfaces. This document does not include recommendations for members of the general community. See here: for more In health care settings, the main infection prevention and information about WHO advice of use of masks in the general control (IPC) strategies to prevent or limit COVID-19 community. transmission include the following:2 In this context, PPE includes gloves, medical/surgical face 1. ensuring triage, early recognition, and source control masks - hereafter referred as “medical masks”, goggles, face (isolating suspected and confirmed COVID-19 shield, and gowns, as well as items for specific procedures- patients); 3 filtering facepiece respirators (i.e. N95 or FFP2 or 2. applying standard precautions for all patients and FFP3 standard or equivalent) - hereafter referred to as including diligent hand hygiene; “respirators" - and aprons. This document is intended for 3.
    [Show full text]
  • Laryngospasm Caused by Removal of Nasogastric Tube After Tracheal Extubation: Case Report
    Yanaka A, et al. J Anesth Clin Care 2021, 8: 061 DOI: 10.24966/ACC-8879/100061 HSOA Journal of Anesthesia & Clinical Care Case Report pCO2: Partial pressure of carbon dioxide pO : Partial pressure of oxygen Laryngospasm Caused by 2 mmHg: Millimeter of mercury Removal of Nasogastric Tube mg/dl: Milligram per deciliter mmol/L: Millimole per litter after Tracheal Extubation: Case Introduction Report Background Laryngospasm (spasmodic closure of the larynx) is an airway Ayumi Yanaka1 and Takuo Hoshi2* complication that may occur when a patient emerges from general 1Department of Anesthesiology and Critical Care Medicine, Ibaraki Prefectur- anesthesia. It is a protective reflex, but may sometimes result in al Central Hospital, Japan pulmonary aspiration, pulmonary edema, arrhythmia and cardiac 2Department of Anesthesiology and Critical Care Medicine, Clinical and Edu- arrest [1]. It does not often cause severe hypoxemia in the patient, and cational Training Center, Tsukuba University Hospital, Japan our review of the literature revealed no previous reports of such cases that cause of the laryngospasm was the removal of nasogastric tube. Here, we describe this significant adverse event in a case and suggest Abstract ways to lessen the possibility of its occurrence. We obtained written informed consent for publication of this case report from the patient. Background: We report a case of laryngospasm during nasogastric tube removal. Laryngospasm is a severe airway complication after Case report surgery and there have been no reports associated with the removal of nasogastric tubes. A 54-year-old woman height, 157 cm; weight, 61 kg underwent abdominal surgery (partial hepatectomy with right partial Case Report: After abdominal surgery, the patient was extubated the tracheal tube, and was removed the nasogastric tube.
    [Show full text]
  • Role and Value of the Corporate Medical Director
    ACOEM GUIDANCE STATEMENT Role and Value of the Corporate Medical Director J. Brent Pawlecki, MD, MMM, Wayne N. Burton, MD, Cherryl Christensen, DO, MS, K. Andrew Crighton, MD, Richard Heron, MB, ChB, FRCP, T. Warner Hudson, MD, Pamela A. Hymel, MD, MPH, and David Roomes, FFOM, FACOEM, ACOEM Corporate Medical Directors Section Task Force accreditation in occupational medicine or the more preferred double The role of the corporate medical director (CMD) has evolved over the last certification in occupational medicine, and another board such as 300 years since Ramazzini first identified diseases of Italian workers in the 01/04/2019 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3VFjldD2uL9p7SMbj5XQFggscApMlmW/UgXNoK/5MD7Gq31Q2YQqh0A== by https://journals.lww.com/joem from Downloaded Downloaded internal medicine or family medicine. Further qualifications such as a early 1700s. Since then, there has been a gradual blurring of the boundaries master of public health or masters-level degree in environmental between private and workplace health concerns. Today’s CMD must have health, business administration, or law are highly desirable, including from intimate knowledge of their corporation’s industry and the businesses that knowledge of epidemiology, biostatistics, population health manage- https://journals.lww.com/joem they support, particularly the occupational and environmental programs that ment, business management, and regulatory aspects of employee comply with all local, state, and/or national standards and regulations. health. CMDs should also remain active in their relevant professional Leading companies not only measure compliance with such standards but health organizations to demonstrate that they are remaining current in also may hold programs to their own internal corporate global standards even medicine.
    [Show full text]
  • Standards, Principles and Approaches in Occupational Health Services
    STANDARDS, PRINCIPLES AND APPROACHES IN OCCUPATIONAL HEALTH SERVICES Jorma Rantanen, Igor A. Fedotov This article is based on the standards, principles and approaches embodied in the ILO Occupational Health Services Convention, 1985 (No. 161) and its accompanying Recommendation (No. 171); ILO Occupational Safety and Health Convention, 1981 (No. 155) and its accompanying Recommendation (No. 164); and the Working Document of the Twelfth Session of the Joint ILO/WHO Committee on Occupational Health, 5-7 April 1995. The ILO Occupational Health Services Convention (No. 161) defines “occupational health services” as services entrusted with essentially preventive functions and responsible for advising the employer, the workers and their representatives in the undertaking on the requirements for establishing and maintaining a safe and healthy working environment which will facilitate optimal physical and mental health in relation to work and the adaptation of work to the capabilities of workers in the light of their state of physical and mental health. Provision of occupational health services means carrying out activities in the workplace with the aim of protecting and promoting workers’ safety, health and well-being, as well as improving working conditions and the working environment. These services are provided by occupational health professionals functioning individually or as part of special service units of the enterprise or of external services. Occupational health practice is broader and consists not only of the activities performed by the occupational health service. It is multidisciplinary and multisectoral activity involving in addition to occupational health and safety professionals other specialists both in the enterprise and outside, as well as competent authorities, the employers, workers and their representatives.
    [Show full text]
  • Heat Stress and PPE During COVID-19: Impact on Health Care Workers’ Performance, Safety and Well-Being in NHS Settings
    medRxiv preprint doi: https://doi.org/10.1101/2020.09.22.20198820; this version posted September 23, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Heat Stress and PPE during COVID-19: Impact on health care workers’ performance, safety and well-being in NHS settings. Sarah L Davey1*., Ben J Lee1., Timothy Robbins2,3., Harpal Randeva2, C. Doug Thake1. 1 Occupational and Environmental Physiology Group, Centre for Sport, Exercise and Life Sciences, (CSELS), Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom. 2 University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom. 3 Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom Corresponding author: Sarah Davey E-mail: [email protected] Key words: PERSONAL PROTECTIVE EQUIPEMENT; HEAT STRESS; HEALTH CARE WORERS, SARS-COV-2 (COVID-19); EXTREME ENVIRONMENTS; HEAT-RELATED ILLNESS. NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. 1 medRxiv preprint doi: https://doi.org/10.1101/2020.09.22.20198820; this version posted September 23, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Abstract Background: The impermeable nature of PPE worn by health care workers (HCWs) during the SARS-CoV-2 (COVID-19) pandemic can potentiate heat stress which may negatively impact the performance, safety and well-being of HCWs.
    [Show full text]
  • Occupational Hygiene Report Writing
    BACK TO BASICS PEER REVIEWED Occupational hygiene report writing Peter-John “Jakes” ABSTRACT Jacobs Occupational hygiene reports record occupational hygiene exposure assessments. Although their (MPH Occ. Hygiene) Cas Badenhorst (PhD purpose and format can vary, they must provide adequate information for managing occupational Occ. Hygiene) risks and so ensure the health and safety of employees. This article describes how to write a good occupational hygiene report, specifi cally with respect to the minimum content and style. Corresponding author: E-mail: jakes.jacobs2@ Key words: occupational hygiene report, content, standards sasol.com INTRODUCTION When the target audience is the senior management of an The fi ndings of occupational hygiene exposure assessments organisation, the report needs to be concise and prefer- are recorded in occupational hygiene reports. The purpose ably no longer than one page with the technical and other of these reports can vary, for example providing commu- information contained in an appendix. A popularly recounted nication to management, employees, health and safety anecdote is that the average reading ability of a company’s representatives, engineers, etc. regarding occupational chief executive offi cer is equitable to that of a 14-year-old, the hazards present in the workplace, addressing emergencies reason being that they are burdened with massive amounts and, importantly, provide practical exposure control advice of data that must be digested on a daily basis. This report and, are critical in managing occupational risks.1 Although can typically be a summary of fi ndings as described in the several formats for the reports exist, they should all serve detailed occupational hygiene report.
    [Show full text]
  • Hanging, Strangulation and Other Forms of Asphyxiation
    Hanging, Strangulation and Other Forms of Asphyxiation Steven Campman, M.D. Chief Deputy Medical Examiner San Diego County 16 October 2018 Overview • Terms • Other forms of asphyxiation • Neck Compression –Hanging –Strangulation Asphyxia • The physical and chemical state caused by the interference with normal respiration. • A condition that interferes with cells ability to receive or use oxygen. General Effects • Decrease and cessation of breathing • Leads to bradycardia and eventually asystole • Slowing, then flattening of the EEG Many Terms • Gag: to obstruct the mouth • Choke: to compress or otherwise obstruct the airway • Strangle: asphyxia by external compression of the throat •Throttle: same as strangle; especially manual strangulation • Garrote: strangle; especially ligature strangulation •Burking: chest compression and smothering. Many Terms • Suffocate: (broad term) a layperson’s synonym for asphyxiation, sometimes used to mean smother. • Choke –a layperson’s term for strangulation –A medical term for internal blocking of the airway Classification of Asphyxia Neck Airway Mechanical Exclusion Compression Obstruction Asphyxia of Oxygen Airway Obstruction •Smothering •Gagging •Choking (laryngeal blockage, aspiration, food bolus) Suicide Kit Choking Internal obstruction of airway • Mouth: gag • Larynx or trachea: obstruction by foreign body, “café coronary,” anaphylaxis, laryngospasm, epiglottitis • Tracheobronchial tree: aspiration, drowning FOOD BOLUS Anaphylaxis from Wasp Stings Mechanical Asphyxia Ability to breath is compromised
    [Show full text]
  • Occupational Exposure to Heat and Hot Environments
    Criteria for a Recommended Standard Occupational Exposure to Heat and Hot Environments DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Cover photo by Thinkstock© Criteria for a Recommended Standard Occupational Exposure to Heat and Hot Environments Revised Criteria 2016 Brenda Jacklitsch, MS; W. Jon Williams, PhD; Kristin Musolin, DO, MS; Aitor Coca, PhD; Jung-Hyun Kim, PhD; Nina Turner, PhD DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health This document is in the public domain and may be freely copied or reprinted. Disclaimer Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH). In addition, citations of websites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these websites. Ordering Information This document is in the public domain and may be freely copied or reprinted. To receive NIOSH documents or other information about occupational safety and health topics, contact NIOSH at Telephone: 1-800-CDC-INFO (1-800-232-4636) TTY: 1-888-232-6348 E-mail: [email protected] or visit the NIOSH website at www.cdc.gov/niosh. For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.gov/ niosh/eNews. Suggested Citation NIOSH [2016]. NIOSH criteria for a recommended standard: occupational exposure to heat and hot environments. By Jacklitsch B, Williams WJ, Musolin K, Coca A, Kim J-H, Turner N.
    [Show full text]
  • The “Best” Way to Breath
    Journal of Lung, Pulmonary & Respiratory Research Case Report Open Access The “Best” way to breath Abstract Volume 2 Issue 2 - 2015 A “best” way to breath is described resulting from discovering a pre-Heimlich method Samuel A Nigro of preventing choking. Because of four episodes in three months of terrifying complete laryngospasm, the physician-patient-writer, consistent with many medical discoveries Retired, Assistant Clinical Professor Psychiatry, Case Western Reserve University School of Medicine, USA in history, discovered a method of aborting the episodes. Breathing has always been taken for granted as spontaneously and naturally most efficient. To the contrary, Correspondence: Samuel A Nigro, Retired, Assistant Clinical nasal breathing is best with first closing the mouth which enhances oxygenation and Professor Psychiatry, Case Western Reserve University School trans-laryngeal respiration. Physiologic aspects are reviewed including nasal and oral of Medicine, 2517 Guilford Road, Cleveland Heights, Ohio respiratory distinctions, laryngeal musculature and structures, diaphragm control and 44118, USA, Tel (216) 932-0575, Email [email protected] neuro-functional speculations. Proposed is the SAM: Shut your mouth, Air in nose, and then Mouth cough (or exhale). Benefits include prevention of choking making the Received: January 07, 2015 | Published: January 26, 2015 Heimlich unnecessary; more efficient clearing of the throat and coughs; improving oxygenation at molecular level of likely benefit for pre-cardiac or pre-stroke anoxic crises; improving exertion endurance; and offering a psycho physiologic method for emotional crises as panics, rages, and obsessive-compulsive impulses. This is a simple universal public health technique needing universal promulgation for the integration of care for all work forces and everyone else.
    [Show full text]