Cover Page

• Because many hazardous exposures from environmental and occupational sources either manifest as common medical problems or have nonspecific symptoms, an exposure history is vital for correct diagnosis.
• By taking a thorough exposure history, the primary care clinician can play an important role in detecting, treating, and preventing disease due to toxic exposure.

This educational case study document is one in a series of self-instructional modules designed to increase the primary care provider’s knowledge of exposures to hazardous substances and to promote the adoption of medical practices that aid in the evaluation and care of potentially exposed patients. The complete series of Case Studies in Environmental Medicine is located on the ATSDR Web site at URL: https://www.atsdr.cdc.gov/csem/csem.html. In addition, the downloadable PDF version [PDF – 695 KB] of this educational series and other environmental medicine materials provides content in an electronic, printable format, especially for those who may lack adequate Internet service.

We gratefully acknowledge the work of the medical writers, editors, and reviewers in producing this educational resource. Contributors to this version of the Case Study in Environmental Medicine are listed below.

Please Note: Each content expert for this case study has indicated that there is no conflict of interest that would bias the case study content.

ATSDR Authors: Dianyi Yu, MD

ATSDR Planners: Charlton Coles, PhD; Kimberly Gehle, MD, MPH; Sharon L. Hall, PhD; Delene Roberts MSMHC; Julia Smith, MPH, CHES; Germania Pinheiro MD, MSc, PhD; Dianyi Yu, MD

Peer Reviewers: Dan Middleton, MD; Mohammed S. Uddin, MD, MPH

Disclaimer

The state of knowledge regarding the treatment of patients potentially exposed to hazardous substances from both environmental and occupational sources is constantly evolving and is often uncertain. In developing its educational products, ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. ATSDR, however, makes no claim that the environmental/occupational medicine and health education resources discussed in these products comprehensively address all possible situations related to various substances. The products are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients potentially exposed to hazardous substances. The products are not a substitute for a health-care provider’s professional judgment. Please interpret the environmental/occupational medicine and the health education resources in light of specific information regarding the patient and in conjunction with other medical authorities.

Use of trade names in ATSDR products is for identification purposes only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.