Week 4 Project In a Microsoft Word document of 4-5 pages formatted in APA style, complete the following assessments (as they pertain to your aggregate) by interviewing 2-3 members of your aggregate: E

Comprehensive Occupational and Environmental Health History

Work History

1. List your current and past longest held jobs, including the military:

2. Do you work full-time? NO ___ YES ___ How many hours per week? ___

3. Do you work part-time? NO ___ YES ___ How many hours per week? ___

4. Please describe any health problems or injuries that you have experienced in connection with your present or past jobs:

5. Have you ever had to change jobs because of health problems or injuries?  YES ___ NO ___ If yes, describe: Did any of your co-workers experience similar problems?

6. In what type of business do you currently work?

7. Describe your work (what you actually do):

8. Have you had any current or past exposure (through breathing or touching) to any of the following?

__acids

__chlorinated naphthalenes

__halothane

__PBBs

__styrene

__alcohols

__chloroform

__heat (severe)

__PCBs

__talc

__alkalies

__chloroprene

__isocyanates

__perchloroethylene

__TDI or MDI

__ammonia

__chromates

__ketones

__pesticides

__toluene

__arsenic

__coal dust

__lead

__phenol

__trichloroethylene

__asbestos

__cold (severe)

__manganese

__phosgene

__trinitrotoluene

__benzene

__dichlorobenzene

__mercury

__radiation

__vibration

__beryllium

__ethylene dibromide

__methylene chloride

__rock dust

__vinyl chloride

__cadmium

__ethylene dichloride

__nickel

__silica powder

__welding fumes

__carbon tetrachloride

__fiberglass

__noise (loud)

__solvents

__x-rays

9. Did you receive any safety training about these agents? YES ___ NO ___ Explain:

10. Are you involved in any work processes such as grinding, welding, soldering, or polishing that create dust, mists, or fumes? YES ___ NO ___ If yes, describe:

11. Did you use any of the following personal protective equipment when exposed?

__boots

__gloves

__shield

__coveralls

__respirator

__sleeves

__earplugs/muffs

__safety shoes

__welding mask

__glasses/goggles

12. Is your work environment generally clean? YES ___ NO ___ If no, describe:

13. What ventilation systems are used in your workplace?

14. Do they seem to work? Are you aware of any chemical odors in your environment (if so, explain)?

15. Where do you eat, smoke, and take your breaks when you are on the job?

16. Do you use a uniform or have clothing that you wear only to work? YES ___ NO ___

17. How is your work clothing laundered (at home, by employer, etc.)?

18. How often do you wash your hands at work and how do you wash them (running water, special soaps, etc.)?

19. Do you shower before leaving the worksite? YES ___ NO ___

20. Do you have any physical symptoms associated with work? YES ___ NO ___ If yes, describe:

21. Are other workers similarly affected? YES ___ NO ___

Home Exposures

1. Which of the following do you have in your home?

__air conditioner __fireplace __electric stove

__central heating (gas or oil) __air purifier __woodstove

2. In approximately what year was your home built?

3. Have there been any recent renovations? YES ___ NO ___ If yes, describe:

4. Have you recently installed new carpet, purchased new furniture, or refinished existing furniture? YES ___ NO ___ If yes, explain:

5. Do you use pesticides around your home or garden? YES ___ NO ___ If yes, describe:

6. What household cleaners do you use? (List most common and any new products you use.)

7. List all hobbies done at your home:

8. Are any of the agents listed earlier for work exposures encountered in hobbies or recreational activities?  YES ___ NO ___

9. Is any special protective equipment or ventilation used during hobbies? YES ___ NO ___ Explain:

10. What are the occupations of other household members?

11. Do other household members have contact with any form of chemicals at work or during leisure activities?  YES ___ NO ___ If yes, explain:

12. Is anyone else in your home environment having symptoms similar to yours? YES ___ NO ___ If yes, explain briefly:

Community Exposures

1. Are any of the following located in your community?

__industrial plant __major source of air pollution __waste site

__landfill __toxic spill __other_____________

2. What is your source of drinking water?

__private well  __public water source  __other

3. Are neighbors experiencing any health problems similar to yours?  YES ___ NO ___ If yes, explain:

Key Occupational and Environmental Health Questions To Be Asked With All Histories

1. What are your current and past longest held jobs?

2. Have you been exposed to any radiation or chemical liquids, dusts, mists, or fumes?  YES ___  NO ___

3. Is there any relationship between current symptoms and activities at work or at home?  YES ___  NO ___

From Pope AM, Snyder MA, Mood LH, editors: Nursing, health, and environment: strengthening the relationship to improve the public's health, Washington, DC, 1995, National Academy Press.