Qualifying for certification in the specialty of occupational medicine.

There are currently a variety of pathways toward certification in occupational medicine. These options may be a source of confusion for potential candidates. As such, this report is offered as a guide for those attempting to complete the requirements for Board eligibility in occupational medicine.

Clinical preventive medicine in business and industry: the economic impact.

Profits and earnings are the most important objectives for companies. Clinical preventive medicine programs reduce an employee's risk factors for illness, reduce absenteeism, and increase productivity. These programs can produce significant physiologic benefits for the employee, regardless of involvement level by the company. Cost-benefit analysis reveals benefit from smoking cessation, fitness, and some educational programs. The employer benefits from a happier and healthier work force which impacts on the public image.

Clinical preventive medicine in business and industry: a rational foundation.

The individual educational and intervention emphasis of clinical preventive medicine programs is successful in reducing an employee's risk for disease and injury. Although some studies note that decreased risk is found predominantly in those with low initial risk, a critical mass of healthful lifestyles may spread to non-participants in the organization, the halo effect. Thus, the more employees there are modeling a health lifestyle, the greater likelihood others will follow. Preventive medicine programs offer intangible advantages to the employer. Such programs demonstrate an attitude of caring for the employee which has an influence on the public. Happier employees tend to increase their level of socialization within a company. The ultimate effect is decreased employee risk, improved productivity, reduced absenteeism, and improved health at reduced cost.

Occupational illness in Oklahoma.

This study estimates the extent of work-related chronic disease fatalities in Oklahoma. Occupational cancer, pneumoconiosis, and chronic respiratory, cardiovascular, renal, and neurological diseases are addressed specifically. Also, the costs of chronic occupational illness are estimated. Because many cases of work-related disease find their way to the primary care physician, an individual who often has little formal training in the recognition and diagnosis of occupational or environmental illness, the education of primary care physicians and medical students in occupational disease recognition and prevention is encouraged.

Decompression sickness: an increasing risk for the private pilot.

Decompression sickness is not an appreciated hazard among the private pilot community. This is of growing concern with the increasing number of nonpressurized aircraft capable of flying to altitudes in excess of 5,468 m (18,000 ft). A case report is presented of a 42-year-old pilot who apparently experienced decompression sickness at flight level 250 which went unrecognized until several months after the incident.

Medication and the work environment.

Each year in the United States physicians write more than 1.5 billion prescriptions for their patients. Considering this scope of drug ingestion it seems safe to assume that medication is taken by some people while they are at work. The therapeutic effects or adverse reactions of drugs may compromise safety in the workplace. Furthermore, the conditions of the job or work environment may adversely alter the expected pharmacokinetics of some agents.

Occupational medicine support for international air carriers.

Although aviation medical support to flight deck crews and cabin staff has been the subject of numerous articles, information about occupational medical support to ground crews, maintenance personnel, and other behind-the-lines personnel who help to "keep them flying" has rarely been presented. This report discusses the occupational medical support provided by six major U.S. international air carriers. Each carrier arranges for medical support of employees through a variety of health care systems, ranging from an airline medical department to total use of contract medical services. Approximately 70% of the airline personnel are non-flying and consequently come under the provisions of classical occupational medical services. Further, many of the flying personnel who may have sustained injuries or illnesses as a result of their aviation occupation also are managed in classical occupational medicine terms. Several airline medical directors interviewed estimate that 65% or more of their professional time is concerned with classical occupational medicine activities rather than aviation medicine programs as usually defined. A major challenge to international air carriers is the numerous jurisdictional arenas concerned with workers' compensation regulations and law under which they operate.

Aeromedical considerations for flight operations from high-elevation airfields.

High-elevation airfields are available to commercial and military aviation. Rapid ascent to locations at high elevations may result in symptoms of altitude sickness in aircrew, support personnel, and passengers. In the United States there are 302 airfields at altitudes in excess of 1,524 m (5,000 ft); in other areas of the world, field elevations can exceed 4,267 m. The symptom complex which may occur at altitude is reviewed and recommendations are offered to prevent, ameliorate, or manage the symptoms.

Aircrew medical standards and their application in the Royal Australian Air Force.

Aircrew selection and health maintenance are key factors in the Aviation Medicine Program of the Royal Australian Air Force. The physical standards employed by the RAAF in selecting aircrew are reviewed. The aircrew selection process for the 5 years 1969 to 1973 are presented with emphasis given to medical causes for rejection. A careful analysis of reasons for failure to complete aircrew training was conducted. The results of this analysis are presented with special emphasis being given to medical wastage. The process of medical evaluation of trained aircrew is discussed along with the 1969-1973 experience with aircrew duty restrictions and waivers granted for medical conditions. The RAAF experience with medical wastage of trained aircrew is similar to the experience of other nations, both as to wastage rates and body systems involved.