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Occupational Medicine, 3d ed.

Occupational illnesses and injuries result in significant morbidity and mortality. Estimates place the number of new disabling occupational illnesses at more than 390,000 per year and the number of occupationally related deaths at 100,000 per year, yet there is a serious shortage of residency-trained occupational medicine physicians. Even with the several thousand additional non-residency-trained physicians practicing occupational medicine, a significant percentage (perhaps 80%) of workers receive occupation-related health care from their primary care physician.

The goal of the third edition of Zenz's text is to provide basic information on the clinical and operational aspects of occupational medicine. This edition has a pronounced international flavor, with contributions from many well-recognized experts in international occupational medicine.

The book is organized into eight sections. The 11 chapters in Part I (Clinical Factors) address a wide variety of clinical subjects, including the following, which are of special interest to the primary care physician: "The Role of the Primary Care Physician in Occupational Medicine" and "Determination of Fitness to Work." Occupational trauma, dermatoses, toxicology, and ocular injuries are also covered in Part I. Part II focuses solely on pulmonary diseases. The "Physical Occupational Environment" (Part III) addresses such topics as ergonomics, video display terminals, radiation, heat and cold, vibration, and hearing loss. Part IV explores the chemical environment to which workers are exposed. Part V addresses issues of special concern, such as "Women in the Workplace," reproductive toxicology, and occupational issues of agricultural and hazardous waste workers. The remaining three sections focus on behavioral issues in occupational medicine; disciplines related to occupational medicine, such as occupational health nursing and industrial hygiene; and special areas, such as health promotion, travel medicine and substance abuse in the workplace.

Several new chapters have been added to the latest edition. The chapter on "Cumulative Trauma Disorders (CTD) of the Upper Extremity" is superbly written and helps to clarify the current epidemic of CTDs. The discussion of indoor air pollution highlights the issue of this problem in the home, a subject often ignored in favor of the more widely publicized outbreaks of "sick building syndrome." The new chapters on travel medicine and health promotion are excellent and have application for any primary care physician whose practice involves travel medicine or who has an interest in health promotion.

There are few problems with this edition. Although coverage of the Americans With Disabilities Act is scant, the discussion of employment entrance examinations should be read by all physicians who do "preplacement" physical examinations. The physician involved with occupational issues in health care workers may be disappointed in the lack of information about the Occupational Safety and Health Administration's bloodborne pathogen program. The binding of the copy that I reviewed was poor. The clarity of some of the photographs also was poor but did not detract from the coverage of the subjects.

Occupational medicine physicians or primary care physicians with large occupational components to their practice should strongly consider purchasing this new edition. Primary care physicians with peripheral involvement in occupational health might be better served by purchasing one of the paperback texts such as Occupational Medicine by LaDou, or Handbook of Occupational Medicine by McCunney.
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Author:Carroll, Dale
Publication:Journal of Family Practice
Article Type:Book Review
Date:May 1, 1994
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