The Practice >> OccMed
Fever at Work
by Dr. Roy Mangubat
Fever at Work
Commonly we encounter patients with febrile illness in the Company Clinic requesting a Leave Pass and a Medical Certificate. During the height of the Infuenza A H1N1 pandemic, it is very usual to see Security Personnel armed with Infrared Thermometer scanning everybody entering the company's premises. Any Febrile employee are not allowed to enter regardless of the cause. Company officials that time know too well the dilemma that the Influenza A H1N1 may bring, During the 1960's when the Inluenza Pandemic hit China it crippled many factories and had disrupted their economy.
Infectious vs. non infectious Etiology
In my own practice, the infectious kind is the most common cause of febrile illness at work. Diseases like Acute Upper Respiratory Tract infections, Pneumonia, Skin and subcutaneous infections are the most usual.
The non-infectious form I usually see in the clinic is Metal Fume Fever, patient come in with fever accompanied by teary and bloodshot eyes – having been exposed to fumes during welding (tig/arc welding or by cutting). This occurs when the worker do not use proper PPE's. Before a worker be engage in welding processes, he/she is ask first to obtain a Hot Work Permit coming from the Safety Engineer. The Safety Engineer inturn makes sure that the welder has adequate training & skills in welding and properly suited-up (with PPE's) before handing down the Hot Works Permit. Metal Fume Fever are also commonly seen in Smelting plants and other metal/steel industries that has furnaces in their operations. Intervention in this kind of hazard would include:
- Engineering Control - Good ventilation/isolation
- Administrative Control – Limit the time of exposure of workers
- PPE - Face Mask, Respirator
The Monday Morning Fever (non-infectious)
It is a term use by OccMed practioners in the industrial setting where febrile episodes starts during the working days and wanes during the weekends and days off. Inhalation Fever ( metal fume fever, polymer fume fever, humidifier fume fever) are the common culprit. Other causes of Monday morning fever may include:
- Extraneous work activities that brings about dehydration. Dehydration perse may cause body temperature elevation
- Psychogenic Causes – Stress and Chronic Fatigue Syndrome
The author is a diplomate of the Philippine College of Occupational Medicine (PCOM). PCOM is an accredited Occupational Health and Safety Organization of the Bureau of Working Conditions of the Department of Labor and Employment (DOLE), a subspecialty society under the Philippine Medical Association (PMA). PCOM is also affiliated with the International Commission on Occupational Health (ICOH) and the Asian Association of Occupational Health (AAOH).
7/18/10
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