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Advanced organizer Chapter 2

Starting from the disease : a latex allergy problem in a health care worker

a five-step procedure: (1) disease; (2) exposure; (3) other possible causes; (4)

judgment as to the disease is work related or not; (5) intervention.

A 32-year-old female is referred to the clinic by the occupational physicianbecauseof a recent onset of rhinitis and wheezing. Her occupational history was that she hadworked as a nurse in the emergency department for7 years and in an internal wardfor 3 years. Her medical history included a food allergy (kiwis, nuts, bananas,tomatoes, among others) and aCaesarean 4 years ago and during surgery she hadan anaphylactic reaction (severe hypotension and tachycardia).When she returned to work after pregnancy leave, shereacted with itchingbumpson her hands, minutes after putting on latex gloves. She noticed that hercondition improved significantly when she was on her days off.

Latex-specific IgEtesting and skin prick testing confirmed the suspicion of latexallergy. As important preventive measure she was advised to no longer use latexgloves. She was able to continue her work as a nurse until aweek ago.During a workactivity involving frequent gloves change, she started to have nasal symptoms andshortness of breath. Her colleague was wearing latex gloves.

How would you further diagnose and treat this nurse?

We can refer the students to USA based Hospital eTool : do we have an European

alternative?

Use the Hospital eTool : this website focuses on the risks in a hospital setting for

various health care workers. It contains graphical menus and expert system

modules that enable the user to answer questions, and receive advice on OSHA

regulations. The additional information starts with a picture of a hospital where you

can click on 15 different departments. Legislation is USA based.

http://www.osha.gov/SLTC/etools/hospital/index.html

http://www.osha.gov/SLTC/etools/hospital/hazards/latex/latex.html

Starting from the exposure : the garage

a four-step procedure: (1) hazards; (2) exposure assessment; (3) characterize therisk; (4) management of risk (collective and individual).

We can make an own movie, inspired by the Dutch Labour Inspection!!! They

realized a short video with dangerous situations for young auto-mechanics. We can

do the same for occupational hazards and exposures.

Go to the following url (in Dutch) : http://zelfinspectie.nl/garage/

http://www.osha.gov/SLTC/etools/hospital/index.htmlhttp://www.osha.gov/SLTC/etools/hospital/hazards/latex/latex.htmlhttp://zelfinspectie.nl/garage/http://www.osha.gov/SLTC/etools/hospital/index.htmlhttp://www.osha.gov/SLTC/etools/hospital/hazards/latex/latex.htmlhttp://zelfinspectie.nl/garage/

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You click on >verder ; on the second slide you click on the clothes of the man

(wear appropriate clothes is the message!). Continue >naar de garage and you

have a walk-through the garage. You can click on things you observe. There are 10

dangerous items and you get feedback and tips if you dont find the answers.