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Taking an Exposure History
What Are the Components of an Exposure History?

Course: WB 2579
CE Original Date: June 5, 2015
CE Renewal Date: June 5, 2017
CE Expiration Date: June 5, 2019
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Learning Objectives

Upon completion of this section, you will be able to

  • Describe the components of an exposure history.

What Should an Exposure History Be Composed of?

An exposure history has three components:

  1. Exposure Survey,
  2. Work History, and
  3. Environmental History.

The main aspects of an exposure history (summarized in Table 4) will be elicited through the exposure history form. For the sample form and links to available formats, see Appendix I.

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. Each clinical encounter may not require an extensive environmental and occupational exposure evaluation, but having exposure history information in the patient's medical record can alert the health care provider to potential exposure risks that may lead to adverse health effects. As in all data-gathering activities, sound clinical judgment should be exercised when analyzing and interpreting patient data within a clinical context.

Table 4. Components of an Exposure History

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, and
    • 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?,
    • Shower before leaving work?,
    • Change shoes and clothing before leaving work?, and
    • Launder work clothing at work?

Part 2. Work History

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

Part 3. Environmental History

  • Present and previous home locations,
  • Present and previous daycare/school settings (as applicable),
  • Jobs of household members,
  • Home insulating and heating and cooling system,
  • Home cleaning agents,
  • Pesticide exposure,
  • Water supply (especially drinking water supply),
  • Recent renovation/remodeling,
  • Air pollution, indoor and outdoor,
  • Hobbies and recreational activities (e.g., painting, photography, sculpting, welding, woodworking, piloting, restoring automobiles, shooting firearms, creating stained glass, creating ceramics, soldering, and gardening),
  • Hazardous wastes/spill exposure,
  • Home ventilation/moisture control/flooding, and
  • Food source(s).

Key Points

  • Each clinical encounter may not require an extensive environmental and occupational exposure evaluation, but having exposure history information in the patient's medical record can alert the health care provider to potential exposure risks that may lead to adverse health effects.
  • It is important for primary health care providers to obtain a complete exposure history for the medical record of each patient.
  • Obtaining the components of the exposure history can be accomplished in several ways including patient assisted completion of exposure history forms.

   

Progress Check

7.Which of the following statements is NOT TRUE?

A. All patients should complete the exposure history forms, although the form may not need extensive evaluation in every clinical situation.
B. A negative response to all questions should rule out a toxic exposure etiology or significant previous exposure.
C. An exposure history form has three components: exposure survey, work history, and environmental history.
D. Hobbies are generally a very important part of the environmental history.

Answer:

To review relevant content see this entire section.

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