Health Problem Diagnostic Checklist

Environmental Health Problem Diagnostic Checklist

From: Health Problem Diagnostic Checklist
Co-sponsored by: The American Lung Association (ALA),
The Environmental Protection Agency (EPA),
The Consumer Product Safety Commission (CPSC), and
The American Medical Association (AMA)
U.S. Gov't Printing Office Publication No. 1994-523-217/81322 1994

It is vital that the individual and the health care professional comprise a cooperative diagnostic team in analyzing diurnal and other patterns that may provide clues to a complaint's link with indoor air pollution. A diary or log of symptoms correlated with time and place may prove helpful. If an association between health symptoms and environmental events or conditions in the home or workplace is not volunteered by the individual, answers to the following questions may be useful, together with the medical history.

The health care professional can investigate the patient's environmental health problems by matching the individual's signs and symptoms to those pollutants with which they may be associated, as detailed in the discussions of various pollutant categories.

When did the [symptom or complaint] begin?
Does the [symptom or complaint] exist all the time, or does it come and go? That is, is it associated with times of day, days of the week, or seasons of the year?
(If so) Are you usually in a particular place at those times?
Does the problem abate or cease, either immediately or gradually, when you leave there? Does it recur when you return?
What is your work? Have you recently changed employers or assignments, or has your employer recently changed location?
(If not) Has the place where you work been redecorated or refurnished, or have you recently started working with new or different materials or equipment? (These may include pesticides, cleaning products, craft supplies, et al.)
What is the smoking policy at your workplace? Are you exposed to environmental tobacco smoke at work, school, home, etc.?
Describe your work area.
Have you recently changed your place of residence?
(If not) Have you made any recent changes in, or additions to, your home?
Have you, or has anyone else in your family, recently started a new hobby or other activity?
Have you recently acquired a new pet?
Does anyone else in your home have a similar problem? How about anyone with whom you work? (An affirmative reply may suggest either a common source or a communicable condition.)

NOTE: A more detailed exposure history form, developed by the U.S. Public Health Service's Agency for Toxic Substances and Disease Registry (ATSDR) in conjunction with the National Institute for Occupational Safety and Health, is available from: Allen Jansen, ATSDR, 1600 Clifton Road, N.E., Mail Drop E33, Atlanta, Georgia 30333, (404) 639-6205. Request "Case Studies in Environmental Medicine #26: Taking an Exposure History." Continuing Medical Education Credit is available in conjunction with this monograph.

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