Appendix C.

Selected Illnesses Which May Result From Exposure in the Work Environment Page 1 of 22

OSHA Record Keeping Guidelines

Appendix C. Selected Illnesses Which May
Result From Exposure in the Work
Environment
OSHA Record Keeping - Guidelines - Table of Contents

z Chapter Number: APP C

z Chapter Title: Appendix C. Selected Illnesses Which May Result
From Exposure in the Work Environment

Appendix C. Selected Illnesses Which May Result From Exposure

in the Work Environment

The following table is included for information purposes only, to

assist employers in recognizing certain occupational illnesses and
diseases. It does not include every condition, illness, or disease that may
result from an exposure in the work environment.

The table is based upon a Sentinel Health Event (Occupational) List

(SHEO), initially prepared by the National Institute for Occupational
Safety and Health (NIOSH), which encompassed 50 disease conditions
linked to the workplace. A Sentinel Health Event (Occupational) is defined
by NIOSH as a disease, disability,or untimely death which is
occupationally related and whose occurrence may: (1) provide the
impetus for epidemiologic or industrial hygiene studies; or (2) serve as a
warning signal that materials substitution, engineering control, personal
protection, or medical care may be required. The list included only those
conditions for which NIOSH found "objective documentation of an
associated agent, industry, and occupation. . . . in the scientific
literature." NIOSH has indicated that the list will be expanded in the
future.

The following table lists illness conditions, the industry and/or occupation
where each condition is likely to occur, symptoms associated with each
condition, and the appropriate illness column to be checked on the log,
OSHA no. 200.

Recording illnesses has historically been a problem for employers,

especially chronic or long term latent illnesses. This table is furnished to
assist employers in making accurate illness determinations. The table

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Appendix C. Selected Illnesses Which May Result From Exposure in the Work Environment Page 2 of 22

should not be interpreted to mean that a specific condition can

only be contracted in the industries or occupations listed. It also
does not mean that every condition listed is recordable if
experienced by employees in these industries and/or occupations.
For the case to be OSHA recordable, employers must still establish that
the condition is a result of an exposure in their work environment. For
guidelines for determining work relationship, see chapter V, section C.

___________________________________________________________________________
| Industry | | | Log
Condition | and/or | Symptoms | Agent | col-
| occupation | | | umn
______________|_______________|_____________________|________________|_____
Pulmonary | Physicians, | Tuberculous lesion; | Mycobacterium |
Tuberculosis.| medical | chest pain; cough- | tuberculosis..| 7c
| personnel, | ing; bloody and | |
| medical | pus-like sputum; | |
| laboratory | hectic fever; | |
| workers. | weight loss; or | |
| | night sweats. | |
| | | |
Silicon | Quarrymen, | Decrease in maximum | SiO(2), |
tuberculosis.| sandblasters,| breathing capacity;| Mycobacterium |
| silica | massive fibrosis; | tuberculosis..| 7b
| processors, | pronounced, | |
| mining, metal| energetic or | |
| foundries, | labored respiration| |
| ceramic | with low oxygen | |
| industry. | content in arteries| |
| | producing bluish | |
| | skin and mucous | |
| | membrane discolora-| |
| | tions; bloodstained| |
| | sputum; attacks of | |
| | bronchopneumonia; | |
| | malaise; disturbed | |
| | sleep; anorexia; | |
| | chest pains; or | |
| | hoarseness. | |
| | | |
Plague........| Shepherds, | Acutely inflamed and| Yersinia pestis|
| farmers, | painful lymph | via bite of |
| ranchers, | nodes; pulmonary | infected flea,|
| hunters, | lesions; cough; | wild rodents, |
| field | chills; 103 deg. - | or inhalation.| 7g
| geologists, | 106 deg. F | |
| medical | temperature; rapid | |
| laboratory | and thready pulse, | |
| workers. | hypertension; rest-| |
| | lessness; delirium;| |
| | confusion; | |
| | incoordination; | |
| | headache; vomiting;| |
| | or diarrhea. | |
| | | |
Tularemia.....| Hunters, fur | Ulcer at bite site | Francisella |
| handlers, | followed by | tularensis via|
| sheep | inflammation of | bite of flies,|
| industry | regional lymph | fleas, ticks, |
| workers, | nodes; a nonspeci- | and lice or |

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| cooks, | fic rash; headache;| handling |

| veterinar- | muscle pains; | infected |
| ians, | chills; nausea; | animals.......| 7g
| ranchers, | vomiting and rapid | |
| veterinary | rise in temperature| |
| pathologists,| to 103 deg. - 104 | |
| forestry | deg. F with severe | |
| workers, | prostration; ex- | |
| farmers, | treme weakness; and| |
| butchers, | drenching sweats --| |
| laboratory | all symptomatic of | |
| workers. | a typhoid-like | |
| | state; bacteremia; | |
| | and atypical | |
| | pneumonia. | |
| | | |
Anthrax | Shepherds, | Cutaneous Form: Red-| Bacillus |
(diagnosis of| farmers, | brown papule skin | anthracis.....| 7g
anthrax as an| butchers, | eruption which en- | |
occupational | handlers of | larges with red | |
disease | imported | patches of variable| |
hinges upon | hides or | size and shape; | |
determination| fibers, vet- | pus-like pimples; | |
of occupa- | erinarians, | and hardening of | |
tion) | veterinary | tissue. Progressive| |
| pathologists,| ulceration follows | |
| weavers. | with blood and pus | |
| | bursting from the | |
| | pimples and dead | |
| | tissue forming. | |
| | Local lymph node | |
| | enlargement is | |
| | accompanied by | |
| | general feeling of | |
| | illness; muscle | |
| | pain; headache; | |
| | fever; nausea; and | |
| | vomiting. | |
| | Pulmonary Form: | |
| |Symptoms are | |
| |insidious, suggest-| |
| |ing an influenza- | |
| |like illness. | |
| |Increased fever is | |
| |followed in 1-3 | |
| |days by severe | |
| |respiratory | |
| |distress with | |
| |bluish-purplish | |
| |discoloration of | |
| |mucous membranes | |
| |and skin; shock; | |
| |and coma. | |
| | | |
Brucellosis...| Farmers, | Remittant undulatory| Brucella |
| shepherds, | evening fever for | abortus, suis.| 7g
| veterinar- | 1-5 weeks; head- | |
| ians, labora-| aches and back-of- | |
| tory workers,| neckaches; morning | |
| slaughter- | sweats with lowered| |
| house | fever; weakness and| |
| workers. | aching without | |

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| | localized findings.| |
| | Is repetitive with | |
| | remissions over | |
| | months or years. | |
| | Cervical pain; | |
| | constipation; | |
| | occasional | |
| | diarrhea; anorexia;| |
| | weight loss; | |
| | irritability; | |
| | insomnia; mental | |
| | depression; emo- | |
| | tional instability.| |
| | Enlarged spleen and| |
| | lymph nodes may | |
| | occur. | |
| | | |
Tetanus.......| Farmers, | Lockjaw; spasms, | Clostridium |
| ranchers. | primarily of | tetani........| 7g
| | maseter and neck | |
| | muscles and second-| |
| | arily of the back | |
| | muscles; stiffness | |
| | of the jaw; rest- | |
| | lessness; irritabi-| |
| | lity; constipation;| |
| | stiff neck; | |
| | difficulty in | |
| | swallowing; stiff | |
| | arm or legs; | |
| | headache; fever; | |
| | sore throat; | |
| | chilliness; painful| |
| | convulsions. | |
| | | |
Rubella.......| Medical | Pale pink rash or | Rubella virus..| 7g
| personnel, | measles-like | |
| intensive | eruptions following| |
| care | slight fever and | |
| personnel. | and inflammation of| |
| | mucous membranes of| |
| | head, nose, throat;| |
| | sore throat; pains | |
| | in limbs; cough; | |
| | intense intolerance| |
| | of light. | |
| | | |
Hepatitis A | Day care | Anorexia; fever; | Hepatitis A |
(infectious).| center staff,| liver enlargement | virus.........| 7g
| orphanage | and tenderness; | |
| staff, mental| generalized debili-| |
| retardation | tation; drowsiness;| |
| institution | nausea; headache; | |
| staff, | occasionally | |
| medical | jaundice. | |
| personnel. | | |
| | | |
Hepatitis B | Nurses and | Flu-like feeling; | Hepatitis B |
(serum)......| aids, anethe-| weakness; | virus.........| 7g
| siologists, | drowsiness; | |
| orphanage and| anorexia; nausea; | |
| mental insti-| abdominal | |
| tution staff,| discomfort; fever; | |

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| medical |
headache; definite | |
| laboratory |
jaundice. | |
| personnel, | | |
| general | | |
| dentists, | | |
| oral | | |
| surgeons, | | |
| physicians. | | |
| | | |
Non-A, non-B | As above for | Nausea; vomiting; | Unknown; |
hepatitis | hepatitis | jaundice; stupor; | suspected |
(toxic)......| A & B. | coma; toxic | drugs and |
| | effects on kidney, | chemicals |
| | brain, or bone | include; |
| | marrow may be more | Carbon tetra- |
| | conspicuous. | chloride, in- |
| | | secticides, |
| | | industrial |
| | | solvents, and |
| | | various |
| | | metallic |
| | | compounds |
| | | (arsenic, |
| | | gold, mercury,|
| | | iron).........| 7g
| | | |
Rabies........| Veterinarians,| Malaise or general | Rabies virus...| 7g
| animal and | feeling of illness | |
| game wardens,| or discomfort; | |
| lab | depression of | |
| researchers, | spirits; swelling | |
| farmers, | of lymphatics | |
| ranchers, | around wound; | |
| trappers, | choking; spasmodic | |
| cave | catching of breath,| |
| explorers, | succeeded by | |
| delivery | increasing spasms, | |
| personnel. | especially of the | |
| | muscles of | |
| | respiration and | |
| | swallowing, which | |
| | are increased by | |
| | attempts to drink | |
| | water or even by | |
| | sight of water. | |
| | Also, fever; | |
| | headache; mental | |
| | derangement; | |
| | nausea; vomiting; | |
| | profuse secretion | |
| | of a sticky saliva;| |
| | and albumin in the | |
| | urine. Usually | |
| | fatal within | |
| | 2-5 days. | |
| | | |
Ornithosis....| Psittacine | Chills; headache; | Chlamydia |
| bird (parrot | dry cough; feverish| psittaci......| 7g
| and parakeet)| and slow pulse; | |
| breeders, pet| lethargy; insomnia;| |
| shop staff, | abnormal fear of | |
| poultry | light; sore throat;| |
| producers, | nausea; vomiting; | |

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| veterinar- | diarrhea; protein | |

| ians, zoo | in urine; anorexia;| |
| employees, | abnormal white | |
| taxidermists,| blood cell count; | |
| laboratory | enlarged but non- | |
| and hospital | tender liver; and | |
| personnel. | commonly, inflamma-| |
| | tion of lungs. | |
| | Severe cases | |
| | include muscle | |
| | pain with stiffness| |
| | and spasms; | |
| | delirium and | |
| | stupor. | |
| | | |
Hemangiosar- | Vinyl chloride| A malignant tumor | Vinyl chloride |
coma of the | polymeriza- | composed of | monomer; |
liver........| tion | cancerous thin and | arsenical |
| industry, | flat scale-like | pesticides....| 7g
| vintners | cells forming | |
| (winemaker). | vessel-like spaces | |
| | in some instances. | |
| | | |
Malignant | Woodworkers, | Malignant tumor; | Unknown; |
neoplasm of | cabinet and | headache; pain; | Hardwood |
nasal | furniture | paralysis of the | dusts; radium;|
cavities.....| makers; boot | lateral rectus | chromates; |
| and shoe | muscle of the eye. | nickel........| 7g
| industry; | | |
| radium | | |
| chemists and | | |
| processors; | | |
| dial | | |
| painters; | | |
| chromium | | |
| producers, | | |
| processors, | | |
| users; | | |
| nickel-smelt-| | |
| ing and | | |
| refining. | | |
| | | |
Malignant | Asbestos | Hoarseness; acute | Asbestos.......| 7g
neoplasm of | industries | laryngitis; polyp | |
larynx.......| and | of a vocal cord; | |
| utilizers. | dropped voice | |
| | pitch which | |
| | becomes monotone; | |
| | voicelessness; | |
| | difficult or | |
| | labored breathing. | |
| | | |
Malignant | Asbestos | Chronic cough; | Asbestos; coke |
neoplasm of | industry and | localized wheeze; | oven |
trachea, | utilizers, | collapsed portion | emissions; |
bronchus, | topside coke | of lung with | radon |
and lung.....| ovens | shrinkage of chest | daughters; |
| workers, | wall and diminution| chromates; |
| uranium | of chest movement | nickel; |
| fluorspar | and breath sounds; | arsenic; |
| miners, | scanty and mucoid | mustard gas; |
| chromium | sputum unless an | bis(chloro- |
| producers and| infection away from| methyl) ether;|

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| processors, | bronchial obstruc- | chloromethyl |

| users, | tion occurs; | methyl ether..| 7g
| nickel | occasional spitting| |
| smelters, | of blood or bloody | |
| processors, | sputum; severe, | |
| users, | constant, | |
| smelters, | nonpleuritic, | |
| mustard gas | unilateral pain; | |
| formulators, | sometimes a remote | |
| ion exchange | metastasis, | |
| resin makers,| especially in the | |
| chemists. | brain, occurs; | |
| | advanced | |
| | state-weight loss, | |
| | anorexia weakness, | |
| | horseness, bone | |
| | pain. | |
| | | |
Mesothelioma | Asbestos | Primary tumor | Asbestos.......| 7g
(MN of | industries | composed of cells | |
peritoneum) | and | similar to those | |
(MN of | utilizers. | forming lining of | |
pleura)......| | the peritoneum, | |
| | pericardium, or | |
| | pleura. | |
| | | |
Malignant | Dial painters,| Fracture may be | Radium.........| 7g
neoplasm of | radium | first clue to bone | |
bone.........| chemists and | cyst, pain, | |
| processors. | swelling. | |
| | | |
Malignant | Automatic | Scrotal mass | Mineral/cutting|
neoplasm of | lathe | progressively | oils; soots |
scrotum......| operators; | increasing in | and tars, tar |
| metalworkers;| size; sometimes | distillates...| 7g
| coke oven | associated with | |
| workers; | pain; minor trauma;| |
| petroleum | hemorrhaging may | |
| refiners, tar| produce extreme | |
| distillers, | local pain, and | |
| chimney | tenderness. | |
| sweeps. | | |
| | | |
Malignant | Rubber and | Discharge of blood | Benzidine, |
neoplasm of | dye workers. | or pus-filled | alpha and beta|
bladder......| | urine; pain or | naphthylamine,|
| | burning while | auramine, |
| | urinating; colicky | magenta, |
| | pain accompanying | aminobiphenyl,|
| | obstruction; | 4-Nitrophenyl.| 7g
| | frequent urination.| |
| | | |
Malignant | Coke oven | Pain; malignant mass| Coke oven |
neoplasm of | workers. | or tumor of the | emissions.....| 7g
kidney, | | connective tissues,| |
other, and | | muscles, urogenital| |
unspecified | | system, vascular | |
urinary | | system, and epith- | |
organs.......| | elial lining of the| |
| | coelom; discharge | |
| | of bloody urine; | |
| | fever; anorexia; | |
| | nausea; vomiting; | |

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| | hypertension. | |
| | | |
Lymphoid | Rubber | Abrupt onset of | Unknown; |
leukemia, | industry, | fever with | ionizing |
acute........| radiologists.| secondary infection| radiation.....| 7g
| | of mouth, throat, | |
| | or lungs; joint | |
| | pains; thrombocyto-| |
| | penia (decrease in | |
| | absolute number of | |
| | platelets below | |
| | normal) may cause | |
| | minute rounded | |
| | spots of hemorrhage| |
| | on skin, mucous | |
| | membrane, or organ,| |
| | and discoloration | |
| | of skin due to | |
| | blood vessel | |
| | rupture, plus | |
| | bleeding from | |
| | mouth, nose, | |
| | kidneys, and bowel.| |
| | Moderate enlarge- | |
| | ment of liver, | |
| | spleen, and lymph | |
| | nodes and | |
| | progressive weak- | |
| | ness and pallor. | |
| | | |
Myeloid | Occupations | Fatigue; weakness; | Benzene; |
leukemia, | with exposure| anorexia; weight | ionizing |
acute........| to benzene; | loss; moderately | radiation.....| 7g
| radiologists.| enlarged spleen | |
| | causing epigastric | |
| | stress or a heavy | |
| | feeling; sternal | |
| | tenderness reflects| |
| | hypercellurity of | |
| | the marrow; minor | |
| | lymph node | |
| | enlargement; | |
| | thrombocytopenia | |
| | (decrease in | |
| | absolute number of | |
| | blood platelets | |
| | below normal) | |
| | followed by | |
| | hemostasis (arrest | |
| | of a flow of blood | |
| | or hemorrhage). | |
| | | |
Erythro- | Occupations | Rare form of | Benzene........| 7g
leukemia.....| with exposure| leukemia in which | |
| to benzene...| multiple | |
| | hemorrhages, | |
| | especially from the| |
| | base of the tongue | |
| | and gums occur; | |
| | plus an | |
| | uninterrupted fall | |
| | of both the white | |
| | and red blood cell | |

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| |
count of the blood;| |
| |
fever; aplastic | |
| |
anemia. | |
Hemolytic | Whitewashing | Weakness; vertigo; | Copper sulfate;|
anemia, non- | and leather | headache; tinnitus;| arsine, |
autoimmune...| industry; | spots before the | trimellitic |
| electrolytic | eyes; easy fatiga- | anhydride; |
| processes, | bility; drowsiness;| naphthalene...| 7d
| arsenical | irritability; | |
| ore smelting;| euphoria; psychotic| |
| plastics | behavior; occasion-| |
| industry; | ally amenorrhea | |
| dye, | (absence of men- | |
| celluloid, | struation); loss | |
| resin | of libido; or | |
| industry. | low-grade fever; | |
| | gastrointestinal | |
| | complaints and | |
| | congestive heart | |
| | failure. Charact- | |
| | erized by jaundice;| |
| | enlargement of the | |
| | spleen; and | |
| | evidence of | |
| | accelerated blood | |
| | destruction. Hemo- | |
| | lytic crises are | |
| | accompanied by | |
| | malaise, chills, | |
| | and fever; aching | |
| | in the extremities,| |
| | back, and abdomen; | |
| | and the presence | |
| | of hemoglobin and | |
| | methoglobin in the | |
| | urine which is | |
| | diminished in the | |
| | amount excreted | |
| | over 24 hours if | |
| | the blood destruc- | |
| | tion is intravacu- | |
| | lar. In chronic | |
| | hemolytic anemia, | |
| | liver enlargement | |
| | and pigment gall- | |
| | stones as well as | |
| | chronic leg ulcers | |
| | are often seen. | |
| | | |
Aplastic | Explosives | Usually insidious, | TNT: Benzene; |
anemia.......| manufactur- | but can be | ionizing | 7d
| ing, occupa- | explosive in deve- | radiation.....| 7e
| tions with | lopment. Waxy | |
| exposure to | pallor of skin and | |
| benzene, | mucous membranes. | |
| radiologists,| Chronic cases show | |
| radium | brown skin | |
| chemists, | pigmentation. If | |
| and dial | decrease in | |
| painters. | absolute number of | |
| | platelets is | |
| | below normal | |
| | (thrombocytopenia),| |

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| |
blood may rupture | |
| |
into mucous mem- | |
| |
branes and skin. | |
| |
Hemorrhages into | |
| |
occular fundi are | |
| |
frequent. Severe | |
| |
sore throat assoc- | |
| |
iated with sharp | |
| |
reduction in number| |
| |
of granulocytes | |
| |
(agranuloctic | |
| |
angina) may occur. | |
| |
Spleen enlargement | |
| |
is absent. | |
Agranulo- | Occupations | Acute disease char- | Benzene; |
cytosis of | with exposure| acterized by marked| phosphorus; |
neutropenia..| to benzene, | leukopenia and | inorganic |
| explosives | neutropenia (below | arsenic.......| 7d
| and pesticide| normal number of | |
| industries, | leukocytes and | |
| pesticides, | neutrophils per | |
| pigments, | unit volume of | |
| pharmaceuti- | peripheral blood) | |
| cals. | and with ulcerative| |
| | lesions of the | |
| | throat and other | |
| | mucous membranes, | |
| | of the gastro- | |
| | intestinal tract | |
| | and of the skin. | |
| | Two or three days | |
| | of fatigue or over-| |
| | powering weakness | |
| | is followed by | |
| | general ill feel- | |
| | ings, chills, high | |
| | fever, rapid weak | |
| | pulse, sore throat,| |
| | difficulty in | |
| | swallowing, ulcers | |
| | of the oral mucosa,| |
| | and ulcerations of | |
| | the pharyngeal and | |
| | buccal mucosae. | |
| | Prostration is | |
| | extreme. Regional | |
| | lymph disease but | |
| | no enlargement of | |
| | nodes, liver, or | |
| | spleen. Fatal. | |
| | | |
Methemoglo- | Explosives | The oxidized form | Aromatic amino |
binemia......| and dye | of hemoglobin, in | and nitro |
| industries. | which the iron atom| compounds |
| | is trivalent, and | (aniline, TNT,|
| | which is not able | nitroglycerin)| 7d
| | to combine | |
| | reversibly with | |
| | oxygen. Formation | |
| | of large amounts | |
| | of methemoglobin | |
| | prevents the normal| |
| | function of | |

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| |
hemoglobin, that of| |
| |
transporting oxygen| |
| |
in the body thus | |
| |
causing asphyxia of| |
| |
the tissues. When | |
| |
large amounts are | |
| |
present, the blood | |
| |
becomes | |
| |
chocolate-brown in | |
| |
color. The skin | |
| |
takes on a | |
| |
bluish-gray color | |
| |
varying in inten- | |
| |
sity from lilac to | |
| |
a deep leaden hue, | |
| |
and quite different| |
| |
from the | |
| |
bluish-purple color| |
| |
of cyanosis due to | |
| |
a lack of oxygen. | |
| |
This distinctive | |
| |
tint is most | |
| |
noticeable on the | |
| |
cheeks, ears, tip | |
| |
of the nose, and | |
| |
fingernails. | |
| |
Sensation of weak- | |
| |
ness in the knees | |
| |
and a staggering | |
| |
gait follow. If | |
| |
destruction of the | |
| |
red blood cells is | |
| |
severe, anemia | |
| |
occurs and there | |
| |
may also be | |
| |
injuries to the | |
| |
kidney and liver. | |
| |
Jaundice and | |
| |
enlargement of the | |
| |
spleen may occur. | |
| |
Attacks usually | |
| |
develop some hours | |
| |
after employee has | |
| |
left plant and | |
| |
rarely during work.| |
| | | |
Toxic | Battery, | Rapid onset of | Lead; inorganic|
encephalitis | smelter, and | fever; depression; | and organic |
(noninfect- | foundry | loss of conscious- | mercury.......| 7d
ious)........| workers; | ness or coma; | |
| electrolytic | seizures; meningeal| |
| chlorine | symptoms and signs | |
| production; | may be accompanied | |
| battery | by cerebral | |
| makers; | disorder, including| |
| fungicide | alterations of | |
| formulators. | consciousness, | |
| | personality change,| |
| | convulsions, | |
| | tremor, muscle | |
| | weakness of one | |
| | side of the body | |
| | (hemiparesis), and | |

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| | a cranial nerve | |
| | abnormalities, | |
| | progressing within | |
| | a few days of coma | |
| | and death. | |
| | | |
Parkinson's | Manganese | Listlessness and | Manganese; |
disease | processing, |sleepiness by day | carbon |
(secondary)..| battery |but insomnia by | monoxide......| 7g
| makers, |night; muscular | |
| welders, |pains, including | |
| internal |cramps in the | |
| combustion |calves; unsteady | |
| engine |gate; weakness and | |
| industries. |stiffness of the | |
| |limbs; involuntary | |
| |movement of the | |
| |arms, legs, trunk, | |
| |jaw, and head which| |
| |may be severe | |
| |enough to shake the| |
| |bed; occasionally | |
| |uncontrollable | |
| |laughter or crying;| |
| |impulsive acts | |
| |such as running, | |
| |dancing, singing, | |
| |and uncontrolled | |
| |talking; or forced | |
| |movements such as | |
| |falling without | |
| |being able to catch| |
| |oneself. Also, | |
| |absentmindedness; | |
| |mental confusion; | |
| |hallucinations; | |
| |and attacks of | |
| |aggressiveness; | |
| |irritability and | |
| |euphoria; | |
| |hand writing is | |
| |tremulous, letters | |
| |and words cramped, | |
| |and micrographia | |
| |is common; speech | |
| |disturbances | |
| |include run-on | |
| |words and | |
| |sentences, monotone| |
| |voice, loss of | |
| |speech (aphonia); | |
| |impaired | |
| |swallowing; | |
| |masklike face; | |
| |excessive | |
| |salivation and | |
| |sweating. | |
| | | |
Cerebellar | Chemical | Unsteadiness in | Toluene; |
ataxia.......| industry | walking; arm | organic |
| using | tremors; pyramidal | mercury.......| 7g
| toluene, | tract involvement | |
| electrolytic | or posterior | |

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| chlorine |
column disorder may| |
| production, |
be present; the | |
| battery |
motor neurons or | |
| makers, |
peripheral nerves | |
| fungicide |
may be affected; | |
| formulators. |
sometimes optic | |
| |
atrophy, retinitis | |
| |
pigmentosa, | |
| |
paralysis of the | |
| |
eye muscles | |
| |
(ophthalmoplegia), | |
| |
nerve deafness, or | |
| |
mental deteriora- | |
| |
tion. Sketetal | |
| |
changes (scoliosis | |
| |
or spinal curvature| |
| |
and pedal or foot | |
| |
abnormalities) are | |
| |
common. | |
| | | |
Inflammatory | Pesticides, | Numbness, tingling, | Arsenic and |
and toxic | pigments, | and burning of feet| arsenic |
neuropathy...| pharmaceu- | and hands, followed| compounds; |
| ticals, | by muscular weak- | hexane; |
| furniture | ness. There may | methyl N-butyl|
| refinishers, | also be a decrease | ketone; TNT; |
| degreasing | in touch, pain, | CS(2); |
| operations, | and temperature | tri-o-cresyl |
| plastic- | sensation in the | phosphates; |
| coated-fabric| feet and hands, | inorganic |
| workers, | and tendon reflexes| lead; |
| explosives | may be diminished | inorganic |
| industry, | or absent. | mercury; |
| rayon manu- | | organic |
| facturing, | | mercury; |
| plastics, | | acrylamide....| 7g
| hydraulics, | | |
| coke | | |
| industries, | | |
| battery, | | |
| smelter, and | | |
| foundary | | |
| workers, | | |
| dentists, | | |
| chloralkali | | |
| workers, | | |
| chloralkali | | |
| plants, | | |
| fungicide | | |
| makers, | | |
| battery | | |
| makers, | | |
| plastics | | |
| industry, | | |
| paper manu- | | |
| facturing. | | |
| | | |
Cataract......| Microwave and | Progressive, pain- | Microwaves; |
| radar | less loss of | ionizing |
| technicians; | vision unless the | radiation; |
| explosives | cataract swells | infrared |
| industries; | and produces | radiation; |
| radiologists;| secondary glaucoma.| dinitrophenol,|

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| blacksmiths, | Well-advanced | dinitro-o |

| glassblowers,| cataracts appear | cresol........| 7e
| bakers; moth | as gray opacities | |
| repellant | in the lens. Small | |
| formulators, | ones stand out as | |
| fumigators; | dark defects in | |
| explosives, | the red reflex. | |
| dyes, | | |
| herbicide | | |
| and pesticide| | |
| industries. | | |
| | | |
Noise effects | Any industry | Tinnitus -- hissing,| Excessive |
on inner ear.| and/or | ringing, buzzing, | noise.........| 7f
| occupation | humming, thumping, | |
| involving | whistling, or | |
| exposure to | roaring in the ear | |
| excessive | -- may be constant | |
| noise. | or intermittent and| |
| | often accompanied | |
| | by hearing loss. | |
| | Clicking; cracking;| |
| | or ticking sounds | |
| | or abnormal or | |
| | pathological | |
| | sounds, originating| |
| | within the | |
| | patient's body (by | |
| | a muscle contrac- | |
| | tion, etc.) in | |
| | region of the ear | |
| | and audible to | |
| | others as well as | |
| | to the patient. | |
| | | |
Raynaud's | Lumberjacks, | Intermittent pallor | Whole body or |
phenomenon | chain | and sometimes | segmental |
(secondary)..| sawyers, | bluish-purplish | vibration; |
| grinders, | discoloration | vinyl chloride|
| chippers, | (cyanosis) of the | monomer.......| 7f
| vinyl | skin precipitated | |
| chloride | by exposure to | |
| polymeriza- | cold, without | |
| tion | clinical evidence | |
| industry. | of blockage of the | |
| | large peripheral | |
| | vessels and with | |
| | nutritional lesions| |
| | (if present at all,| |
| | limited to the | |
| | skin). Blanching | |
| | and numbing when | |
| | exposed to chilling| |
| | weather or | |
| | emotional upsets | |
| | with probable loss | |
| | of muscular control| |
| | and reduction of | |
| | sensitivity to | |
| | heat, cold, and | |
| | pain are main | |
| | symptoms. Cyanosis | |
| | and pain are rare. | |

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| | Gangrene and | |
| | serious complica- | |
| | tions are very rare| |
| | if, indeed, they | |
| | occur at all. | |
| | | |
Extrinsic | Farmer's lung,| Difficult or labored| Various agents |
allergic | bagassosis, | breathing | (usually a |
alveolitis...| bird | (dyspnea); fever; | fungus or |
| fancier's | and oxygen defic- | mold and |
| lung, sub- | iency (hypoxia) | dusty |
| erosis, malt | during acute phase | substances)...| 7g
| worker's | lasting several | |
| lung, | weeks. Cough with | |
| mushroom | scanty, black, | |
| worker's | stringy, occasion- | |
| lung, maple | ally bloody sputum;| |
| bark disease,| bluish-purple dis- | |
| cheese | coloration of | |
| washer's | mucous membranes | |
| lung, coffee | (cyanosis); patchy | |
| worker's | infiltrates in the | |
| lung, fish- | lung can also | |
| meal worker's| occur. | |
| lung, | | |
| furrier's | | |
| lung, | | |
| sequoiosis, | | |
| wood worker's| | |
| lung, | | |
| miller's | | |
| lung. | | |
| | | |
Extrinsic | Jewelry, alloy| Sudden onset after | Platinum; |
asthma or | and catalyst | exposure to an | isocyanates; |
allergic | makers; | allergen. Sense of | chromium and |
asthma.......| polyurethane,| tightness in the | cobalt; |
| adhesive, | chest due to spas- | aluminum |
| paint | modic contraction | soldering |
| workers; | of the bronchi; | flux; phthalic|
| alloy, | difficult or | anhydride; |
| catalyst, | labored breathing | formaldehyde; |
| refinery | (dyspnea); | gum arabic; |
| workers; | wheezing. Symptoms | N(i)SO(4); |
| solderers, | may subside in one | flour; |
| plastic, dye,| hour or less, | trimellitic |
| insecticide | continue for | anhydride; |
| makers; foam | several hours, or | red cedar and |
| workers; | persist as status | other wood |
| latex | asthmaticus for | dusts; |
| markers; | many days. End of | bacilus- |
| biologists; | attack is marked | derived |
| printing | by pronounced | exoenzymes....| 7e
| industry; | coughing with ex- | |
| nickel | pectoration of | |
| plasters; | thick, tenacious | |
| bakers; | sputum, immediately| |
| plastics | followed by a sen- | |
| industry; | sation of relief | |
| woodworkers; | and "clearing" of | |
| furniture | the air passages. | |
| makers; | Physical signs | |
| detergent | consist of prolon- | |

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| formulators. | gation of expira- | |

| | tion and the | |
| | presence of | |
| | sonorous and | |
| | sibilant rales | |
| | throughout the | |
| | chest; normal but | |
| | labored respira- | |
| | tion; markedly dis-| |
| | tended chest; | |
| | bluish-purplish | |
| | discoloration of | |
| | skin and mucous | |
| | membrances | |
| | (cyanosis). Between| |
| | attacks breathing | |
| | may be quite, but | |
| | forced expiration | |
| | will produce | |
| | sonorous or | |
| | sibilant rales. | |
| | Frequency and | |
| | severity of attacks| |
| | may be greatly | |
| | influenced by | |
| | secondary factors | |
| | (e.g., changes in | |
| | temperature and | |
| | humidity); by | |
| | exposure to noxious| |
| | fumes; by fatigue; | |
| | by endocrine | |
| | changes (puberty, | |
| | menstruation, | |
| | pregnancy, | |
| | menopause); by | |
| | emotional stress. | |
| | Since these | |
| | secondary factors | |
| | may perpetuate | |
| | attacks, attention | |
| | should be directed | |
| | to their control. | |
| | | |
Coalworkers | Coal miners. | Black spit increas- | Coal dust......| 7b
pneumoconio- | | ing in quantity as | |
sis..........| | disease advances; | |
| | jet-black nodules | |
| | and cavities of the| |
| | lung; chest becomes| |
| | barrel-shaped and | |
| | there may be | |
| | clubbing of the | |
| | fingers; right | |
| | heart failure or | |
| | silico-tuberculosis| |
| | may supervene to | |
| | cause death; | |
| | disease is visua- | |
| | lized by X-ray as | |
| | fine, discrete | |
| | pinhead mottling or| |
| | nodulation or dense| |

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| | conglomerate | |
| | shadows resembling | |
| | angel's wings; | |
| | eventually large | |
| | fibrotic masses | |
| | develop and diffi- | |
| | cult or labored | |
| | breathing with | |
| | cough ensue. | |
| | | |
Asbestosis....| Asbestos | Progressive, | Asbestos.......| 7b
| industries | difficult, or | |
| and | labored breathing | |
| utilizers. | (dyspnea); nonpro- | |
| | ductive cough | |
| | (little or no | |
| | sputum), unless | |
| | pulmonary TB is | |
| | present yielding | |
| | bloodstained | |
| | sputum; slight | |
| | pain between the | |
| | shoulders, under | |
| | shoulder blades, or| |
| | sternum; visualized| |
| | by X-ray as fine | |
| | pulmonary fibrosis | |
| | enmeshed with | |
| | asbestos bodies | |
| | giving a ground | |
| | glass appearance; | |
| | increased suscepti-| |
| | bility to lung | |
| | cancer; pleural | |
| | plaques and calci- | |
| | fications are often| |
| | present in the | |
| | fibrous tissues | |
| | and emphsema is | |
| | extensive, but | |
| | localized to lower | |
| | and apical parts | |
| | of the lungs. | |
| | | |
Silicosis.....| Quarrymen, | Discrete nodulation | Silica.........| 7b
| sandblasters,| in the absence of | |
| silica | emphsema is usually| |
| processors, | asymptomatic. It is| |
| mining, | the massive conglo-| |
| metal, and | merate fibrosis | |
| ceramic | resulting from the | |
| industries. | coalescence of | |
| | nodules that yields| |
| | symptoms: Difficult| |
| | or labored breath- | |
| | ing (dyspnea) which| |
| | is progressively | |
| | deeper and faster; | |
| | dry cough; malaise;| |
| | disturbed sleep; | |
| | anorexia; chest | |
| | pains; hoarseness; | |
| | bluish | |

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| | discoloration | |
| | of skin and mucous | |
| | membranes (cyano- | |
| | sis); and blood- | |
| | stained sputum with| |
| | bronchopneumonia | |
| | and subsequent | |
| | bronchiectasis | |
| | developing. TB | |
| | often develops. | |
| | Fever is rate. | |
| | Physical signs are | |
| | few or absent. In | |
| | advanced cases | |
| | second palmonic | |
| | heart sound, | |
| | decreased chest | |
| | expansion and | |
| | excursion of | |
| | diaphragm, breath | |
| | sounds and rales | |
| | may be present. | |
| | Right heart failure| |
| | or pus-producing | |
| | bronchopneumonia | |
| | will result in | |
| | death. | |
| | | |
Talcosis......| Talc | Difficult or labored| Talc...........| 7b
| processors. | breathing | |
| | (dyspnea), X-ray | |
| | yields nodular | |
| | shadows distributed| |
| | over both lungs; | |
| | nodules show whorl-| |
| | ing different from | |
| | silicosis and | |
| | contain fiber-like | |
| | structures arranged| |
| | singly and in | |
| | clumps. | |
| | | |
Chronic | Beryllium | Morbid condition of | Beryllium......| 7b
beryllium | alloy | the lungs, more | |
disease of | workers; | rarely of the skin | |
the lung.....| ceramic and | (conjunctivitis and| |
| cathode ray | dermatitis), sub- | |
| tube markers;| cutaneous tissue | |
| nuclear | lymph nodes, liver,| |
| reactor | and other struc- | |
| workers. | tures, character- | |
| | ized by formation | |
| | of granulomas | |
| | (tumors). Chronic | |
| | granulomatous | |
| | pneumoconiosis with| |
| | thickening of | |
| | alveolar walls. An | |
| | acute transient | |
| | inflammation of | |
| | respiratory tract | |
| | (nasal passages | |
| | and pharynx) yield-| |

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| | ing nosebleeds, | |
| | bronchitis or | |
| | pneumonitis. | |
| | Symptoms of | |
| | respiratory | |
| | insufficiency with | |
| | diffusion diffi- | |
| | culty (weakness, | |
| | anorexia, weight | |
| | loss, malaise, | |
| | dyspnea or deeper | |
| | and faster breath- | |
| | ing, cyanosis or | |
| | bluish | |
| | discoloration | |
| | of skin or mucous | |
| | membranes, and | |
| | cough) are most | |
| | prominent and out | |
| | of proportion to | |
| | physical or X-ray | |
| | signs. Resembles | |
| | military TB or | |
| | pulmonary | |
| | sarcoidosis. | |
| | (Onset may be 5 | |
| | years after | |
| | exposure.) | |
| | | |
Byssinosis | Cotton | Periodic broncho- | Cotton, flax, |
| industry | constriction or | hemp, cotton- |
| workers. | Monday morning | synthetic |
| | fever with wheezing| dusts.........| 7b
| | and difficult or | |
| | labored breathing | |
| | upon return to | |
| | work after 2-day | |
| | absence. Later | |
| | develops into | |
| | severe airway | |
| | obstruction and | |
| | impaired elastic | |
| | recoil due to | |
| | chronic bronchitis,| |
| | and emphysema. | |
| | Patient has over- | |
| | distended lungs but| |
| | no characteristic | |
| | X-ray pattern or | |
| | recognizable lung | |
| | fibrosis or infil- | |
| | tration are seen. | |
| | Diagnosis is estab-| |
| | lished by measuring| |
| | the patient's | |
| | ventilatory | |
| | capacity before he | |
| | starts work on | |
| | Monday and again no| |
| | more than 1 hour | |
| | after his work | |
| | shift. (Develops | |
| | over 10-year period| |

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| | working with raw or| |

| | waste cotton.) | |
| | | |
Acute | Refrigeration,| Acute inflammation | Ammonia; |
bronchitis, | fertilizer, | of the tracheo | chlorine; |
pneumonitis, | oil refining | bronchial tree. | nitrogen |
and | industries, | Symptoms are those | oxides; sulfur|
pulmonary | alkali and | of acute URL. In- | dioxides; |
edema due | bleach | flammation of the | cadmium; |
to fumes and | industries, | mucous membranes | trimellitic |
vapors.......| silo filters,| of the nose, | anhydride.....| 7c
| arc welders, | usually marked by | |
| nitric acid | sneezing, nasal | |
| industry, | airway congestion, | |
| paper and | and discharge of | |
| refrigeration| watery mucous | |
| industry, | (coryza); malaise; | |
| oil refining,| chilliness; slight | |
| cadmium | fever; back and | |
| smelters, | muscle pain; sore | |
| processors, | throat. Dry non- | |
| plastics | productive cough | |
| industry. | signals bronchitis,| |
| | later yielding a | |
| | glutinous and | |
| | mucous with pus- | |
| | filled sputum. | |
| | Fever to 101 deg. | |
| | or 102 deg. F | |
| | occurs for | |
| | 3-5 days. Persis- | |
| | tent occasional | |
| | sibilant or crackl-| |
| | ing pulmonary | |
| | sounds may suggest | |
| | complications. | |
| | Pulmonary edema; | |
| | asthmatic wheezing;| |
| | difficulty | |
| | breathing except in| |
| | upright position | |
| | (orthopnea); | |
| | pallor; sweating, | |
| | bluish discolora- | |
| | tion of skin and | |
| | mucous membranes | |
| | (cyanosis); frothy | |
| | or pinkish sputum. | |
| | | |
Toxic | Solvent | Nausea; vomiting; | Carbon |
hepatitis....| utilizers, | jaundice; stupor; | tetrachloride,|
| drycleaners, | and coma may follow| chloroform, |
| plastics | exposure. Toxic | tetrachloro- |
| industry, | effects on kidney, | ethane, |
| explosives | brain, or bone | phosphorus |
| and dye | marrow may be more | TNT; |
| industries, | conspicuous than | chloronaphtha-|
| fire and | the hepatic | lenes; |
| waterproof- | involvement. | methylenedia- |
| ing additive | | niline; |
| formulators, | | ethylene |
| plastics | | dibromide; |
| formulators, | | cresol........| 7d

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|fumigators, | | |
|gasoline, | | |
|fire | | |
|extinguisher | | |
|formulators, | | |
|disinfectant,| | |
|fumigant, | | |
|synthetic | | |
|resin | | |
|formulators. | | |
| | | |
Acute or | Battery | Failure to void; | Inorganic lead;|
chronic | makers, | lumbar pain and | arsine; |
renal | plumbers, | tenderness; and | inorganic |
failure......| solderers, | analysis of urinary| mercury; |
| electrolytic | volume and the | carbon |
| processes, | character of the | tetrachloride;|
| arsenical | urinary sediment | ethylene |
| ore smelting,| is extremely | glycol........| 7d
| battery | valuable in differ-| |
| makers, | ential diagnosis | |
| jewelers, | of acute renal | |
| dentists, | failure. In | |
| fluorocarbon | obstruction, | |
| formulators, | urinary sediment | |
| fire | is scanty, with | |
| extinguisher | only occasional red| |
| makers, | and white blood | |
| antifreeze | cells or hyaline | |
| manufacture. | and granuline | |
| | casts. Proteinuria | |
| | is minimal or | |
| | absent. In prerenal| |
| | failure, occasional| |
| | hyaline and | |
| | granular casts are | |
| | found and protein- | |
| | uria is minimal. | |
| | Urnary sp. gr. is | |
| | usually >1.020 and | |
| | urinary sodium con-| |
| | centration <15 m | |
| | Eq/L. In acute | |
| | tubular necrosis | |
| | numerous, renal | |
| | epithelial cells, | |
| | cell casts, and | |
| | coarsely granular | |
| | casts are present. | |
| | Hb and RBC casts | |
| | are seen occasion- | |
| | ally. Proteinuria | |
| | is minimal or | |
| | moderate. Urinary | |
| | sp. gr. is usually | |
| | <1.018 and sodium | |
| | concentration >20 m| |
| | acute
Eq/L. In | |
| | glomerulonephritis | |
| | and collagen | |

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| |
diseases, hematuria| |
| |
and RBC casts are | |
| |
characteristic and | |
| |
protein excreation | |
| |
is usually moderate| |
| or heavy. | | |
| | | |
Infertility, | Formulators; | Physical examination| Kepone; |
male.........| DBCP | and semen analysis | dibromochloro-|
| producers, | are necessary to | propane.......| 7d
| formulators, | diagnosis and | |
| and | should include | |
| applicators. | work history. | |
| | | |
Contact and | Leather | Transient redness to| Irritants |
allergic | tanning, | severe swelling and| (e.g., |
dermatitis...| poultry | blister (bulla) | cutting oils, |
| dressing | formation; itching | solvents, |
| plants, fish | and vesiculation | phenol acids, |
| packing, | are practically | alkalis, |
| adhesives | always present. | detergents); |
| and sealants | Vesicles and bullas| allergens |
| industry, | rupture, ooze, and | (e.g., nickel,|
| boat | crust; followed by | chromates, |
| building and | scaling and some | formaldehyde, |
| repair. | temporary thicken- | dyes, rubber |
| | ing of skin. | products).....| 7a
| | Secondary infec- | |
| | tion, excoriation | |
| | (skin abrasions), | |
| | and reaction to | |
| | treatment may | |
| | complicate and | |
| | induce a chronic | |
| | eczematous | |
| | dermatitis. | |
| | | |
______________|_______________|_____________________|________________|_____

Columns 1, 2, and 4 based on Rutstein, D.D.; Mullan, R.J.; Frazier, T.M.;

Halperin, W.E.; Melius, J.M.; Sestito, J.P.; "Sentinel Health Events
(Occupational): A Basis for Physician Recognition and Public Health
Surveillance," American Journal of Public Health, 1983; 73(9): 1054-
1062.

Revision Date: Mar 8 1999

OSHA Record Keeping - Guidelines - Table of Contents

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