title: Sentinel pathophysiologic conditions: an adjunct to teaching occupational and environmental disease recognition and history taking.
abstract: Primary care physicians have an increasingly important role in identifying occupational and environmental (O/E) disease. However, the basic skills in O/E history taking, diagnosis, and management have not been adequately incorporated into traditional American medical education or practice. Reasons for these educational barriers are discussed. A new approach to O/E history taking, based on a modified list of occupational sentinel health events, is described. This list will give medical students and residents a practical, directed approach to recognizing O/E conditions and evaluating exposures in formulating a differential diagnosis. Through improved detection and assessment on the part of primary care physicians, appropriate referrals to occupational health specialists can be made for further investigation and public health surveillance.
authors.affiliation: Department of Environmental and Community Medicine, UMDNJ-Robert Wood Johnson Medical School, Piscataway 08854-5635.
authors.forename: H M
authors.initials: HM
authors.lastname: Kipen
authors.forename: J
authors.initials: J
authors.lastname: Craner
mesh_terms: D003937:Diagnosis, Differential; D004501:Education, Medical / Q000379:methods*; D004782:Environmental Health; D006801:Humans; D008487:Medical History Taking / Q000379:methods*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D010821:Physicians, Family / Q000193:education; D011159:Population Surveillance