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The physician has the knowledge and skills to recognize, evaluate, and treat exposures to toxins at work or in the general environment. This most often includes interpretation of laboratory or environmental monitoring test results as well as applying toxicokinetic data. Hazardous material exposures occur at work, at home, and in the general environment. Clinical acumen as well as knowledge of hazardous material databases equip the OEM physician to identify, manage, and prevent occupational and environmental toxicity. General principles of clinical toxicology underlie emergency, non-urgent, and target organ-specific medical management.
1. Determine the nature and extent of potential occupational and environmental chemical exposures,
considering routes of exposure and routes of absorption.
Use appropriate written and computerized databases (e.g., MSDSs, Registry of Toxic Effects of Chemical Substances [RTECS]) to identify the hazardous ingredients of chemical agents.
Identify the physical characteristics of hazardous agents (e.g., liquid/gas/vapor/particulate).
Estimate the likely degree of absorption based upon circumstances of exposure, considering factors such as the nature of the substance, the route of exposure, concomitant exposures, and characteristics of the patient (e.g., age, susceptibility factors).
2. Detect, insofar as possible, preclinical or clinical effects arising from chemical exposure and implement appropriate preventive measures.
Identify, obtain, and evaluate biomarkers or other tests to assess exposure and/or health effects, including biological monitoring techniques that assay the substance, its metabolites, or other indices.
Identify clinical or biochemical evidence of target organ damage when exposure hazard is recognized.
3. Evaluate, treat, and/or properly refer persons whose health may be affected by acute or chronic contact with occupational and environmental chemicals.
Identify the likely toxic exposure on the basis of clinical signs and symptoms.
Identify chronic health effects (e.g., hepatotoxicity, asthma, central and peripheral nervous system toxicity, interstitial fibrosis) resulting from toxic exposure and obtain necessary confirmatory testing.
Manage medical care and secondary preventive measures for individuals chronically affected by toxic exposure.
Assess clinical, worksite, and environmental data, along with literature reviews in the performance of patient evaluations.
Obtain detailed exposure information including exposure histories, MSDSs, industrial hygiene reports, and other data.
Evaluate the severity of exposure to hazardous agents, considering dose/response relationships.
Interpret exposure data in the context of the scientific literature (human and animal) and the patient’s presentation.
Understand, explain, and be able to apply toxicokinetic data (including absorption, metabolism, storage, and excretion) to clinical and employment-related decision-making.
Determine if a person has a health condition that increases risk from the effects of exposure to chemical, physical, or biological agents.
Distinguish health effects of exposure to chemicals from other etiologies.
Use occupational and environmental information resources to conduct a literature search or to research the health effects of a chemical substance.
Interpret and apply the medical, toxicological, and environmental literatures.
Welcome to the Toxicology module.
This module is designed to present topics in medical and industrial toxicology that are relevant to the practice of occupational medicine. The module consists of a number of lessons that address specific chemicals, industrial processes or occupations that include the risk of exposure to hazardous materials or are associated with adverse health effects.
Each module will consist of a learning activity, usually a slide-based presentation, a list of selected references, and a self-assessment module to help you measure your understanding of key concepts in the lesson.
Lessons
Please click on the links below to access the individual topic lessons.
