Agency for Toxic Substances and Disease Registry 
Case Studies in Environmental Medicine (CSEM) 
Taking an Exposure History
What Are the Components of an Exposure History?

Learning Objectives

Upon completion of this section, you will be able to

• describe the components of an exposure history

Introduction

An exposure history form has three components: Exposure Survey, Work History, and Environmental History. The main aspects of an exposure history (summarized in Table 3) will be elicited through the exposure history form.

Although a positive response to any question on the form indicates the need for further inquiry, a negative response to all questions does not necessarily rule out a toxic exposure etiology or significant previous exposure. All patients should complete exposure history forms, although the form does not need extensive evaluation in every clinical situation. As in all data-gathering activities, sound clinical judgment must be exercised.

Part 1. Exposure Survey

• Exposures
  • current and past exposure to metals, dust, fibers, fumes, chemicals, biologic hazards, radiation, noise, and/or vibration
  • typical workday (job tasks, location, materials, and agents used)
  • changes in routines or processes
  • other employees or household members similarly affected
• Health and Safety Practices at Work Site
  • ventilation
  • medical and industrial hygiene surveillance
  • employment exams
  • personal protective equipment (e.g., respirators, gloves, and coveralls)
  • lockout devices, alarms, training, and drills
  • personal habits (Smoke and/or eat in work area? Wash hands with solvents?)

Part 2. Work History

• description of all previous jobs including short-term, seasonal, and part-time employment and military service
• description of present jobs

Part 3. Environmental History

• present and previous home locations
• jobs of household members
• home insulating and heating and cooling system
• home cleaning agents
• pesticide exposure
• water supply
• recent renovation/remodeling
• air pollution, indoor and outdoor
• hobbies (e.g., painting, photography, sculpting, welding, woodworking, piloting, restoring automobiles, shooting firearms, creating stained glass, creating ceramics, and gardening)
• hazardous wastes/spill exposure
• home ventilation/moisture control/flooding

Key Points

• Although a positive response to any question on the form indicates the need for further inquiry, a negative response to all questions does not necessarily rule out a toxic exposure etiology or significant previous exposure.

Progress Check