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Nov/Dec 2009-occupational and environmental health: CPD questionnaires must be completed online via www.cpdjournals.org.za. After submission you can check the answers and print your certificate. Questions may be answered up to 6 months after publication of each issue.

WORK-RELATED CHRONIC OBSTRUCTIVE PULMONARY DISEASE

1. Choose one correct statement regarding an exposed worker who is also a smoker and who presents with signs or symptoms of COPD:

A. His disease cannot be due to his workplace exposures because of his smoking

B. His disease is presumed to be compensable under the Compensation for Occupational Injuries and Diseases Act

C. It is likely that the severity of his disease will be greater than if he had one or the other exposure alone

D. Work contributes a greater risk to the development of COPD than smoking

E. Smoking cessation interventions will be adequate to prevent progression of disease in this individual.

2. True (A) or false (B)--fill in only block A or B:

The Compensation for Occupational Injuries and Diseases Act of 1993 stipulates that workers exposed to hazardous agents must be placed under a medical surveillance programme.

CODES OF ETHICS IN OCCUPATIONAL HEALTH--ARE THEY IMPORTANT?

3. Which one of the following criteria is not normally among the criteria used in an ethical analysis of a moral dilemma in occupational health practice:

A. Doing good

B. Avoiding harm

C. Protection of autonomy and integrity

D. Cost-efficiency

E. Equity/justice.

4. True (A) or false (B)-fill in only block A or B: The community and society are regarded as stakeholders in planning programmes of occupational health services.

WORK-RELATED ASTHMA

5. In an adult presenting with new-onset or worsening asthma, which one of the following clinical activities is least useful in assisting with the diagnosis (choose one):

A. Work exposure history

B. Chest radiograph

C. Spirometry (pre- and post-bronchodilator challenge)

D. Serial peak expiratory flow monitoring at work and away from Work

E. Immunological test (e.g. skin prick test, specific IgE) to a respiratory sensitiser.

6. The common causes of occupational asthma in South Africa are (choose one):

A. Lead, mercury and arsenic

B. Gases such as ozone, nitrogen dioxide and sulphur dioxide

C. Cereal flours, isocyanates (in spray paint) and natural rubber latex gloves

D. Asbestos, silica and coal dust

E. None of the above.

ASSESSMENT OF (DIS)ABILITY IN A PROSPECTIVE COMMERCIAL DIVER WITH A HAND INJURY--A CASE STUDY

7. The most appropriate opinion regarding a patient's fitness for work can be provided by (choose the correct answer):

A. The patient's own general practitioner

B. The treating specialist (e.g. orthopaedic surgeon)

C. An occupational therapist

D. The patient's supervisor at work

E. A team led by an occupational medicine practitioner.

8. The best location to assess an ill or injured person's fitness for work is:

A. A properly equipped medical practice

B. An occupational therapy practice

C. In the employee's workplace

D. A laboratory with standardised work-testing equipment

E. Under water.

HEALTH EFFECTS ASSOCIATED WITH OCCUPATIONAL EXPOSURE TO HEXAVALENT CHROME (CHROMIUM VI)

11. At occupational levels of Cr(VI) near the exposure limit set by OSHA (5 [micro]g/[m.sup.3]), there is strong evidence of a significant risk of (choose one):

A. Lung cancer

B. Stomach cancer

C. Lower-respiratory tract effects

D. Occupational asthma.

12. True (A) or false (B)--fill in only block A or B: Even at occupational levels below the 5 [micro]g/[m.sup.3] exposure limit set in 2006, there is a high risk of upper respiratory tract effects and a risk of dermal effects from the inhalation of Cr(VI).

OCCUPATIONAL HEALTH CONCERNS WITH PESTICIDES IN AGRICULTURE AND BEYOND

13. Notification of a case of pesticide poisoning to the Department of Health is indicated (choose the correct answer):

A. Only in the case of an organophosphate insecticide poisoning

B. Only in the case of a poisoning that did not involve occupational exposure

C. Only in the case of poisoning with a cholinesterase-inhibiting pesticide

D. In any case of pesticide poisoning

E. None of the above.

TUBERCULOSIS IN HEALTH CARE WORKERS

14. When preventing TB transmission in the workplace, the first line of control is (choose the correct answer):

A. Providing personal protective equipment (PPE)

B. Administrative controls

C. Engineering controls.

SILICA, SILICOSIS AND TUBERCULOSIS--RECOGNISING THE CLINICAL LINK

15. True (A) or false (B)--fill in only block A or B: There has to be evidence of silicosis on the chest radiograph for pulmonary tuberculosis to be regarded as caused by occupational factors for compensation purposes.

MEDICAL CERTIFICATION AND PROFESSIONAL QUALIFICATIONS --WHO IS AUTHORISED TO DO THESE?

16. True (A) or false (B)--fill in only block A or B: Work in which there is an obligatory use of respirators does not require a legally specified certificate of fitness.

17. True (A) or false (B)--fill in only block A or B: A postgraduate qualification in occupational health is required before signing a certificate of fitness for hazardous biological agents.

FITNESS TO WORK--WHAT THE GENERAL PRACTITIONER NEEDS TO KNOW

18. True (A) or false (B)--fill in only block A or B:

A general practitioner is not legally allowed to adjudicate on fitness to work for any occupations if he/she does not have additional qualifications.

19. True (A) or false (B)--fill in only block A or B: Certification of fitness to work requires a knowledge of the minimum medical standards of fitness for the applicable occupation.

CLINICAL SCREENING AND MEDICAL SURVEILLANCE FOR ADVERSE HEALTH EFFECTS OF MANGANESE EXPOSURE

20. True (A) or false (B)--fill in only block A or B: An individual's blood manganese level is useful for the diagnosis of manganism.

Accreditation number: MDB001/016/01/2009
COPYRIGHT 2009 South African Medical Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Publication:CME: Your SA Journal of CPD
Article Type:Report
Geographic Code:6SOUT
Date:Nov 1, 2009
Words:911
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