There is no need to need of evaluating a hazardous chemicals training programme if there is no case
of occupational disease after training.
a. True
b. False
Which is true regarding occupational injury or occupational disease
a. An OMP’s primary role in the workplace is for early detection of occupational diseases
b. If the company occupational hygiene report shows that the worker was exposed to OELs
bellow acceptable limits an OMP cannot diagnose an occupational disease.
c. If COID Act does not compensate for the disease, it is not considered as an occupational
disease.
d. A single occupational disease/injury case can warrant changes on company health and safety
policy.
Miss Netshivhuyi is a geologist referred from Sibanye still water gold kloof mine by an OMP to rule
out possible occupational asthma. She has thirteen years working under underground with
exposures to silica dust, diesel emissions from underground and natural gasses and hydrochloric
acid. workplace controls in place are there in the form of surface wetting to control dust , mining
ventilation systems with extractors and natural gas holes sealing strategies and she is minimally
exposed to hydrochloric acid vapour as it is less than 5 minutes in a shift usually with a respirator
mask on. She works 8-hour shifts, 5 days per week wearing full PPE in the form of respirator mask,
safety googles, ear plugs, gloves, overall, safety boots arm and knee guards, hard hat.
This is a patient previously diagnosed with right pulmonary embolism in August 2021 after 8 months
of respiratory symptoms of intermittent cough, fever and chest pain. Health care practitioners first
thought it was COVID-19 symptoms in December 2020 and she tested negative and was treated
multiple times as an LRTI infection. She was admitted for five days and was put on 4 months
treatment of rivaroxaban 20 mg and Sereflo and emboli resolved confirmed by CT chest and
pulmonary scan in December 2022. She is chronically on Foxair 50/500 , Loratadine ,
Consultation, she presented with features suggestive of either a recurrent pulmonary emboli or
residual symptoms post previous emboli or complications of pulmonary emboli or an evidenced by
subjective history of persistent cathemeral chest pain below the left breasts and dry cough and on
review she does have rapid heart beat daily night sweat s dizziness’ at times intermittent fever and
breathlessness. These signs could also be suggestive of an infective process but x-ray did not show
radiological features. She also has history of atopic episode post dust exposure , nasal blockage,
teary eyes send cough.
On examination , had a high pulse rate of 117 beats per minute that was regular in rhythm and , and
on cardiovascular examination the heart rates were also normal. Her fitness watch showed range 60140 pm with analysis past month showed 45-186 beats per minute
Her chest x-rays and spirometry results weren’t suggestive of obstructive airway disease with a
normal FEV1/FVC ratio. On allergy testing done before consultation she showed atopy with 4
aeroallergens and 5 food allergens. Clotting profile, cardiac markers and lupus screen was normal
Differential diagnosis
Recurrent pulmonary embolism or Pulmonary embolism with residual symptoms
Discussion
With the above-mentioned differential diagnosis, infective processes or acquired causes of
hypercoagulable states need to be ruled out like . there also needs to be assessment of Heart
arrhythmia like artrial finrillation which can be a complication or cause PE
There are no known causes of PE due to being gold underground mining probem usually it can be
sisicosis complication but this patient does not have features
The symptoms can also be because of change of environment, especially having to breath under a
respirator mask .
RECOMMENDATIONS
1.
2.
3.
4.
Ruleout PTB – Gene Xpert and AFB
VCT
Connective tissue screening
Rule out Heart arrhythmia