With regard to tumours of occupational origin the following are correct:
(a) probably account for around 3%of all tumours?
true
With regard to tumours of occupational origin the following are correct:
(b) Usually have a short latent period?
false. There is usually a long latent period between time of first exposure and appearance of the tumour.
With regard to tumours of occupational origin the following are correct:
(c) Deaths as a result may occur at a younger age?
True.
Due to the appearance of tumours at an earlier age than would be normally expected. However some tumours of occupational origin may have a very long latent period e.g. asbestos related tumours and in these cases death may be after retirement age.
With regard to tumours of occupational origin the following are correct:
(d) may occur in clusters?
true.
May get an unusually large incidence of a tumour in a particular location related to an exposure in that area.
With regard to tumours of occupational origin the following are correct:
(e) In the aetiology, repeated continuous exposure to a carcinogenic agent is crucial?
false. The exposure does not need to be continuous.
In occupational cancer:
(a) carcinogenesis is a single step process?
False.
It is multi-step.Classically it is initiation, promotion and progression.
In occupational cancer:
(b) Specific genes may be involved in the development of the condition?
true.
- oncogenes
In occupational cancer:
(c) Organotrophy is the term used to describe carcinogenic genetic mutation?
False.
Organotrophy is the term used to describe the induction of tumours at specific sites by chemical carcinogens.
In occupational cancer:
(d) Metal salts account for most occupationally linked cancers?
False.
Chemicals are the group most associated.
In occupational cancer:
(e) The Ames test is an in-vitro test of mutagenicity?
True.
It is used to evaluate the carcinogenic potential of chemicals by looking for a mutagenic effect in bacteria.
Cancer of the skin is associated with ?
pitch, cutting oils and UV light.
sunlight is important to those who work regularly outdoors e.g. roadworkers or farmers, also ionizing radiation.
Carcinoma of the bladder is associated with ?
aromatic amines
eg. benzidine and MOCA, chemical, dyestuff, rubber cable industries.
Tumours of the liver are associated with?
vinyl chloride monomer
- causes angiosarcoma
bronchial carcinoma is associated with?
uranium, nickel carbonyl, chromates and asbestos.
-also arsenic trioxide and arsenites found in smelting and pesticides.
Nasal cancer is associated with?
leather workers, hardwoods and nickel
- nasal cancer is a rare adenocarcinoma, the very fine dust produced by power tools on hardwoods is particularly carcinogenic.
Occupations recognized as having a carcinogenic risk?
(a) road work?
true.
skin cancer due to UV light exposure, also seamen and farmers.
Occupations recognized as having a carcinogenic risk?
(b) shipbuilding?
true
as complications of exposure to asbestos- lung cancer and mesothelioma.
Occupations recognized as having a carcinogenic risk?
(c) hairdressing?
false
Occupations recognized as having a carcinogenic risk?
(d) cabinet making?
true
cancer of the nasal sinuses due to wood dust.
Occupations recognized as having a carcinogenic risk?
(e) drug manufacture?
true
pharmaceutical manufacture of cytotoxic drugs potentially causing bone marrow tumours.
With regard to the relationship between occupation and leukaemia the following are correct:
(a) associated primarily with radium salts?
false.
Radium salts are most associated with osteosarcoma in workers using luminous paints.
With regard to the relationship between occupation and leukaemia the following are correct:
(b) found in some cases of benzene exposure?
true.
frequently as the end point of aplastic anaemia. Myeloid type is commonest.
With regard to the relationship between occupation and leukaemia the following are correct:
(c) associated with the asbestos industry?
false
With regard to the relationship between occupation and leukaemia the following are correct:
(d) linked with ionising radiation exposure?
true.
dose related relationship
With regard to the relationship between occupation and leukaemia the following are correct:
(e) the rubber industry has been implicated?
true
Acute lymphoid leukaemia. Aetiology unknown.
With regard to mesothelioma the following are true:
(a) It is a secondary tumour of peritoneum and pleura?
false.
It is a primary tumour
With regard to mesothelioma the following are true:
(b) most cases in the uk are related to asbestos exposure?
true
With regard to mesothelioma the following are true:
(c) was formerly a prescribed industrial disease?
false.
It still is.
With regard to mesothelioma the following are true:
(d) smoking produces a higher incidence?
false
Smoking does not appear to be a contributory factor, it seems to increase the chance of those exposed to asbestos developing lung cancer.
With regard to mesothelioma the following are true:
(e) Has a latent period of fifteen to twenty five years?
false
latent period is usually forty or more years.
Ergonomics:
(a) aims to optimize working conditions for its human operators.
true
fitting the task to the person
Ergonomics:
(b) makes use of anthropometrics?
True
This is the use of measurements relating to height, shoulder width, reach, arm span etc and body movements.
Ergonomics:
(c) Tries to fit the person to the task
false
the task to the person
Ergonomics:
(d) concentrates largely on equipment design?
false
The environment, the individual, and the work design are also taken into account
Ergonomics:
(e) Has a role in setting patterns of work?
true
Musculoskeletal problems at work may be due to:
(a) Excessive range, frequency and force of movement?
true
Musculoskeletal problems at work may be due to:
(b) Abnormal positioning of limbs?
true
Musculoskeletal problems at work may be due to:
(c) primarily psychological factors?
false.
psychological factors (e.g.stress) may have a bearing but not necessarily a primary role
Musculoskeletal problems at work may be due to:
(d) static loading
true
Musculoskeletal problems at work may be due to:
(e) lack of motivation
false
May contribute to a greater or lesser extent but unlikely to be the sole cause of a musculoskeletal disorder.
Factors contributing to work related upper limb disorders (WRULDs) include:
(a) poor work design- task factors
true
Factors contributing to work related upper limb disorders (WRULDs) include:
(b) environmental factors- such as task lighting and temperature
true
Factors contributing to work related upper limb disorders (WRULDs) include:
(c) inadequate protective equipment
false
only if the PPE contributes to poor work design
Factors contributing to work related upper limb disorders (WRULDs) include:
(d) sudden or prolonged increases in work rates
true
Factors contributing to work related upper limb disorders (WRULDs) include:
(e) inadequate pre-employment assessment?
false
pre-employment assessment will not identify those likely to suffer from WRULDS except if a past history is elicited.
The following are all clinical entities commonly associated with WRULDs:
(a) tenosynovitis
true
The following are all clinical entities commonly associated with WRULDs:
(b) ganglion
false
The following are all clinical entities commonly associated with WRULDs:
(c) carpal tunnel syndrome
true
- also radial and cubital tunnel syndrome
The following are all clinical entities commonly associated with WRULDs:
(d) tendonitis crepitans
true
also tendonitis and de quervains disorder
Features of WRULDs are:
(a) inflammation of tendon or tendon sheaths?
true
or trauma of these structures
Features of WRULDs are:
(b) diagnosis is usually obvious?
false
- diagnosis is difficult
Features of WRULDs are:
(c) finger tip ulceration due to ischaemia?
false
this is a feature of hand arm vibration syndrome
Features of WRULDs are:
(d) relationship with prolonged static postures?
true
Also awkward and extremes of postures
Features of WRULDs are:
(e) dominant hand more often affected?
true
In the carpal tunnel syndrome:
(a) hyperaesthesia is restricted to the median nerve distribution?
true
In the carpal tunnel syndrome:
(b) wrist extension for one minute causes tingling in the fingers (phalens test)?
false
phalens test is wrist flexion for one minute producing tingling in the fingers
In the carpal tunnel syndrome:
(c) there is an association with acromegaly?
true
also myxoedema and fluid retention in pregnancy
In the carpal tunnel syndrome:
(d) tinels test may be positive?
true
- this is tingling in fingers produced by percussion over the carpal tunnel
In the carpal tunnel syndrome:
(e) Forceful, repetitive movements can cause median nerve neuropathy?
true
- due to both mechanical and ischaemic mechanisms
In tenosynovitis:
(a) The principal lesion is inflammation of a tendon?
false
This is tendonitis. Tenosynovitis involves inflammation of the lining of the tendon sheath.
In tenosynovitis:
(b) Excessive unaccustomed exercise may be causative?
true
as well as repetitive microtrauma and strain
In tenosynovitis:
There are no apparent x-ray changes ?
false
calcification on the tendon sheath may on occasion be found
In tenosynovitis:
(d) gentle exercise may give symptomatic relief?
false
Relief is usually provided by rest or immobilisation of the part
In tenosynovitis:
(e) Work related cases are bilateral?
false
Can be either unilateral or bilateral depending on the nature of the work
Salmonella food poisoning?
Onset of symptoms between two to seventy two hours. Biggest single cause of food poisoning in uk.
Associated with poultry and poultry products.
Most common strain is S. typhimurium.
staph aureus food poisoning?
Onset of symptoms in two to six hours.
Organism is found in skin folds, nasal passages and septic skin lesions. A toxin is produced by the bacterium. Recovery is rapid- within six hours.
Clostridium welchii food poisoning?
enterotoxin
onset of symptoms within 8-24hrs
anaerobic organism
found in human and animal excreta as well as on raw meat
illness may last one to three days
bacillus cereus food poisoning?
toxin, spore producing organism
onset of symptoms 1-16 hours
associated with fried rice
clostridium botulinum food poisoning?
Toxin
can be rapidly fatal
onset of symptoms between eighteen to thirty six hours
rare in uk
anaerobic spore producing bacterium which produces a potent toxin
Regarding food hygiene-
conditions for bacterial growth?
- suitable food medium and temperature
- adequate moisture and sufficient time
- bacteria do not multiply below 15 degrees and above 40 degrees
- spores will only be killed at high temperatures such as boiling
Regarding food hygiene-
Risk factors when controlling contamination?
-condition of raw food and hygiene of handlers
-cleansiness of kitchens and equipment
-conditions for food storage
Regarding food hygiene-
assessment of food handlers?
Exclude infectious diseases.
Investigate diarrhoeal illness.
disqualify active and persistent infective discharges from ears, nose and eyes.
Regarding food hygiene-
action following outbreak of food poisoning?
notify public health department
identify affected persons and source for analysis
share info with EHO, local hospitals, labs and GPs
non return to work by those infected until shown by stool sampling to be clear of infection
Regarding food hygiene-
Ideal factory or kitchen environments?
clean premises/ machinery with adequate ventilation and waste disposal
separate cloakroom facilities
maintained refrigerators/chillers for food storage
good hygienic systems of work
trained and informed staff
With regard to microbiological hazards-
There are six bacterial diseases in the schedule of prescribed diseases?
With regard to microbiological hazards-
HIV is a prescribed disease?
false
viral hepatitis as a result of an occupation involving contact with human blood products or contact with a source of viral hepatitis is the only viral disease in the list of prescribed diseases.
With regard to microbiological hazards-
ankylostomiasis is the only helminthic disease in the schedule of prescribed diseases?
true
rare in uk
associated with work in or around mines
With regard to microbiological hazards-
anyone contracting one of the prescribed microbiological diseases is entitled to compensation?
false
contraction of the disease must be in the context of satisfying the occupational requirement as laid down in the schedule of prescribed diseases
With regard to microbiological hazards-
Occupations most at risk include laboratory workers, health care workers and animal handlers?
true
Lyme disease-
Was first recognised in australia?
false
lyme connecticut USA
It is an occupational zoonosis i.e. an infectious disease transmitted from animals to man and contracted in the course of employment
Lyme disease-
Is caused by infectious spores entering the body?
false
It is caused by bacterium borrelia burgdorferri which is transmitted by the tick ixodes ricinus
Lyme disease-
is characterised by erythema multiforme?
False-
it is erythema chronicum migrans - an area of redness spreading out from the bite
Lyme disease-
Has sheep and cattle as the primary animal reservoir in the uk?
false- usually associated with deer
Lyme disease-
May be associated with neurological symptoms following infection?
true
facial nerve neuritis, myelitis, encephalitis and meningitis can all occur as may a myocarditis, chronic polyarthritis may also be found
The following with regard to leptospirosis are correct-
when caused by bacterium L. icterohaemorrhagiae is known as weils disease?
true
it is an occupational zoonosis
The following with regard to leptospirosis are correct-
primary preventative measure is drainage of wet ground?
false-
It is the control of rats whose urine contains the bacteria
The following with regard to leptospirosis are correct-
Is a prescribed industrial disease?
true
The following with regard to leptospirosis are correct-
vaccination is available to workers at risk in uk?
false
The following with regard to leptospirosis are correct-
Is not a serious illness and symptoms subside quickly?
false
it is a serious disease with up to 20% cases being fatal.
With regard to hepatitis B (HBV) the following are correct:
health care workers are particularly at risk?
true- surgical procedures needlesticks
With regard to hepatitis B (HBV) the following are correct:
vaccination for HBV is 100% effective?
false
sero conversion is 80-90%
With regard to hepatitis B (HBV) the following are correct:
There is a recognized risk of transmission in mouth to mouth resuscitation manoeuvres?
false
With regard to hepatitis B (HBV) the following are correct:
No risk of infection following a bite by a known carrier?
false
Can be transmitted by injury or by being bitten by an infectious patient
In hepatitis B (HBV):
A major prolongation of prothrombin time is common?
false
it is uncommon and when present indicates severe illness
In hepatitis B (HBV):
Incubation period of six to twenty five weeks?
true
In hepatitis B (HBV):
Chronicity occurs in over 50% cases?
false
in 5-10% of cases
In hepatitis B (HBV):
presence of HbsAg (surface antigen) indicates acute infection?
true
usually appears during incubationperiod, it is used to diagnose HBV
In hepatitis B (HBV):
There is no association with hepatocellular carcinoma?
false
associated with hepatocellular carcinoma, chronic hepatitis and cirrhosis
The following statements relating to hepatitis A (HAV) are correct:
Incubation period is eight to twelve weeks?
false
two to six weeks
The following statements relating to hepatitis A (HAV) are correct:
sewerage workers may be at risk?
true
The following statements relating to hepatitis A (HAV) are correct:
a vaccine is not available
false
The following statements relating to hepatitis A (HAV) are correct:
most infections are subclinical?
true
and thus unrecognized
The following statements relating to hepatitis A (HAV) are correct:
chronic carrier states are common?
false
HAV has no known carrier state and plays no role in the production of chronic active hepatitis or cirrhosis.
Features of hepatitis C:
Common in children and young adults?
false
Tends to be associated with post- transfusion hepatitis and contaminated needle sharing in drug users.
Features of hepatitis C:
Transmitted in blood and blood products?
true
Features of hepatitis C:
average incubation of 2 to 4 weeks?
false
it is seven to eight weeks
Features of hepatitis C:
vaccination is available for healthcare workers?
false
no vaccine for HCV
In aquired immune deficiency syndrome:
Risk of infection from needlestick injury is greater than for HBV?
false
estimated to be less of a risk
In aquired immune deficiency syndrome:
There is an association with chlaymdiae pneumoniae?
false
associated with pneumocystis carinii pneumonia
In aquired immune deficiency syndrome:
workplace infection risk is low?
true
Anthrax ( B. anthracis)?
Handling of wool, hides and carcases of infected animals. Two forms, cutaneous and pulmonary.
Rare in uk
imported bone/fish meal account for most cases.
Leptospirosis?
flu like illness with jaundice
involves contact with urine of rodents, dogs or bovines.
occupations at risk include: farmers, sewerage workers and watercourse workers.
Brucellosis ( B abortus)?
contracted from infected bovine carcasses or ingesting raw milk
rare in uk
occupational contraction is usually by handling infected animals (placental or fetal tissue particularly)or by inhalation of infected aerosols from such animals.
Hepatitis B?
from infected blood or blood products
Legionellosis ( L. pneumophilia) ?
Occurs in outbreaks
associated with cooling towers and air conditioning systems.
Vapours?
Gaseous form of a substance normally solid or liquid which occurs by the process of evaporation.
fumes?
solid particles generated by condensation from the gaseous state, generally after volatization from molten metals
mists?
suspended droplets generated by condensation from gaseous to liquid state or the breaking up of a liquid into a dispersed state.
aerosols?
liquid droplets or solid particles dispersedin air of a fine enough particle size to remain dispersed for some time.
In toxicology:
Inhalation is a less imporant route of entry for a toxic substance than percutaneous absorption?
false
generally absorption is more effective via the lungs than the gut
In metal toxicology:
some metals undergo biotransformation?
false
no metals are bio- transformed, most are excreted in the urine
In metal toxicology:
Age is an important factor in metal poisoning?
true
in general as age increases the absorption of metals from the gut decreases
In metal toxicology:
dietary considerations are unimportant?
false
constituents of diet may cause interactions e.g. lead absorption varies inversely with calcium and iron in the diet
In metal toxicology:
important factors relating to toxicity are particle size, solubility and interactions between metals.
true. particle size is important for lung absorption ie. they must be respirable. Interactions between metals will influence uptake as will solubility.
In toxicology:
There can be individual susceptibility in reaction to exposure of a toxic substance?
true
In toxicology:
Metabolism of a non- toxic substance may provide a toxic metabolite?
true
The converse is also true.
In toxicology:
Possible toxic include irritation, asthma and asphyxiation?
true
In toxicology:
Latent periods can be associated with most toxic substances?
false
Biological monitoring:
Is applicable to substances that act locally?
false
not usually applicable to locally acting substances or in detecting peak exposures to rapidly acting substances
Biological monitoring:
can be used to detect peak exposures to rapidly acting substances?
false
Biological monitoring:
gives a biological index of an internal dose?
true
This is likely to be more closely related to a systemic effect than any environmental measurement.
Biological monitoring:
takes account of all routes of absorption?
true
and individual variation
Biological monitoring:
Involves measurement of the agent or its metabolite usually in the blood or urine?
true
Definition of biological monitoring?
It is the measurement and assesssment of workplace agents or their metabolites either in tissues, secreta, excreta or any combination of these to evaluate exposure and health risk compared with an appropriate reference standard.
In carbon monoxide poisoning:
There is cyanotic skin discolouration?
false
it is cherry red
In carbon monoxide poisoning:
Hyperbaric oxygen therapy may be used in the treatment?
true
In carbon monoxide poisoning:
Industrial exposure is a common source?
true
In carbon monoxide poisoning:
Death usually occurs with 60-80% carboxyhaemoglobin?
true
In carbon monoxide poisoning:
Industrial exposure is a common source?
true
for example exhaust fumes and afterdamp in mines
With regard to lead the following are correct:
the suspension level for blood in male workers is 70 micrograms/dl (3.5 micromol/l)?
true
With regard to lead the following are correct:
suspension is required when blood lead is greater than 30micrograms/dl (1.5micromol/l)in women of child bearing age?
false
suspension for women of child bearing age: 40micrograms/dl (2.0micromol/l)
70micrograms/dl (3.5 micromol/l) is correct for males
With regard to lead the following are correct:
lead poisoning is one of the most commonest forms of occupational poisoning in the uk?
false
this is the case in developing countries however.
With regard to lead the following are correct:
Inorganic lead is absorbed through the skin?
false
organo-leads may be absorbed throught the skin (tetra-ethyl lead)
With regard to lead the following are correct:
In occupational exposure inhalation is the most common route of entry?
true
Although ingestion remains important especially if personal hygiene is poor leading to contamination of ingested food
In relation to mercury the following statements are true:
Poisoning by mercury or a mercury compound is a prescribed disease?
true
In relation to mercury the following statements are true:
elemental, alkyl and inorganic forms are the most toxic?
true
With regard to mercury the following are correct:
Mercury workers usually have blood mercury levels routinely monitored?
false
It is the periodic measurement of mercury in the urine.
In relation to mercury the following statments are true:
principal target organs are the kidney and CNS?
true
Inorganic mercury does not cross the blood brain barrier as readily as elemental or alkyl forms.
In relation to mercury the following statements are true:
Acute poisoning is common from occupational exposure and is usually due to ingestion?
false
Acute poisoning is not common in an occupational setting. When poisoning does occur it is usually as a result of inhalation of mercury vapours.
With regard to cadmium the following are true:
Acute effects of cadmium poisoning after inhalation of fumes may show a delay in presentation?
true
Acute effects due to inhalation of Cd oxide fumes may show a latent period of up to ten hours- chest pain, dysponea and cough
With regard to cadmium the following are true:
chronic poisoning principally affects the liver?
False
The kidney- tubular damage
With regard to cadmium the following are true:
may get discolouration in teeth?
true
With regard to cadmium the following are true:
Is linked to a high risk of prostate cancer?
false
With regard to cadmium the following are true:
biological monitoring of exposed workers involves both blood and urinary estimations?
true
The following statements relating to arsenic are correct:
Occupational exposure is likely to occur in pesticide/herbicide manufacture and smelting?
true
also in chemical and pharmaceutical industries
The following statements relating to arsenic are correct:
Has a very short half life in the blood?
false
half life in the blood is two to two and a half days, it is rapidly eliminated in the kidney
The following statements relating to arsenic are correct:
chronic poisoning may cause skin changes?
true
skin ulceration, hyperkeratosis of the palms and soles. Hyperpigmentation and eczematous dermatitis.Also skin cancer.
The following statements relating to arsenic are correct:
associated with angiosarcoma of the liver
true
and lung cancer.
The following statements relating to arsenic are correct:
The characteristic respiratory tract lesion is cancer of maxillary sinuses.
false
it is perforation of cartilaginous nasal septum
With regard to manganese the following are correct:
Is well absorbed through the intestine and easily crosses the blood brain barrier?
false
it is poorly absorbed throught the GIT and crosses blood brain barrier with difficulty.
With regard to manganese the following are correct:
poisoning is characterised by two phases?
false
Three phases: general lassitude, tiredness, pain, dysarthria, imbalance and hypersalivation, parkinsons type features
With regard to manganese the following are correct:
Periodic medical examination is useful
true
To detect early behavioural or neuro changes
With regard to manganese the following are correct:
Uptake is associated by iron deficiency?
true
With regard to manganese the following are correct:
An individual susceptibility to poisoning is described?
true
In relation to phosphorus the following statements are true:
red phosphorus is assc with necrosis of the jaw?
false
this is associated with white or yellow phosphorus- phossy jaw.
In relation to phosphorus the following statements are true:
-poisoning is a prescribed disease?
true
In relation to phosphorus the following statements are true:
may cause serious burning of the skin on contact?
true
In relation to phosphorus the following statements are true:
Dental examination is an important feature of monitoring?
true
In relation to phosphorus the following statements are true:
Phosphene gas is a hazard associated with pesticides?
false
a very toxic asphyxiant gas formed in the manufacture of acetylene
With regards to beryllium:
may get an allergic contact dermatitis?
true
With regards to beryllium:
GIT absorption is good?
false, GIT absorption poor lung absorption rapid
With regards to beryllium:
Is associated with chronic pulmonary conditions?
true
called berylliosis
With regards to beryllium:
chronic poisoning is associated with gliomatous
false
It causes sarcoid like granulomatous lesions affecting lungs and s/c tissues.
With regards to beryllium:
blood beryllium levels are a reliable method of biological monitoring?
false, there is no reliable method. found in urine though. CXR and resp function tests to screen
The following statements in relation to glutaraldehyde are true:
has antimicrobial properties?
true
hence it is used as a sterilising agent
The following statements in relation to glutaraldehyde are true:
health care workers are at risk of toxic effects?
true
prinicipally nurses in endoscopy units
The following statements in relation to glutaraldehyde are true:
formic acid in urine is used to monitor exposure?
false
The following statements in relation to glutaraldehyde are correct:
is a known sensitiser?
true
The following statemetns in relation to glutatarldehyde are correct:
has a teratogenic effect?
false not shown to be the case in humans
Regarding vanadium the following statements are correct:
inhalation is the principal route of entry?
true
Regarding vanadium the following statments are correct:
excessive exposure can be associated with a green and black tongue and a metallic taste in the mouth?
true
Regarding vanadium the following statements are correct:
main effects due to over exposure are due to irritation of mucous membranes?
true
it causes respiratory tract irritation and pneumonitis.
Regarding vanadium the following statements are correct:
blood vanadium levels is the preferred method of monitoring?
false
main monitoring urinary vanadium
Vanadium causes a coarse tremor?
false it causes a fine tremor of fingers and hands in cases of toxicity
With regards to chromium the following are true:
trivalent chromium salts are irritant corrosive and carcinogenic?
false
this describes hexavalent salts are carcinogenic in relation to lung cancer, the trivalent salts are virtually non-toxic
With regard to chromium the following are true:
chromium compounds are sensitisers?
true cause contact dermatitis and occ asthma.
With regard to chromium the following are true:
it is no longer a prescribed disease?
false
for chronic skin irritation and lung cancer
with regard to chromium the following are true:
associated with nasal perforation?
true
due to inhalation of chrome vapours
chromium monitoring?
urinary levels - not routinely, but gives index of exposure to soluble hexavalent chromium compounds.
in relation to acrylamide the following are true:
poisoning is associated with polymer and monomers?
false
Only the monomer is toxic
In relation to acrylamide the following are true:
Acute effects are those of irritation to the skin and mucous membranes?
true
blistering of the skin may occur with prolonged contact
In relation to acyrlamide the following are correct:
upper and lower limb parasthesia is a complication of poisoning?
true
peripheral neuropathy is a feature of chronic exposure usually of the legs and hands
In relation to acrylamide the following are true:
inhalation is the commonest route of entry?
false.
Skin absorption is the commonest route
In relation to acrylamide the following are true:
chronic poisoning is associated with mid-brain lesions?
true
ataxia tremor dysarthria and increased sweating.
Lead
amino levalunic acid, blood lead is used more freq as bio monitor.
trichlorehylene?
urinary trichloracetic acid
vinyl chloride monomer?
urinary thiodyglycolic acid
benzene?
urinary phenols
xylene?
urinary methyl hippruric acid
The following cause cataracts?
welding - due to infrared radiation
mercury-f
electrocution- true rarely
beryllium-f causes conjunctivitis
dinitrophenol-t
The following are known to cause peripheral neuropathy?
organophosphates-true
thallium scan-true
acrylamide-true
magnesium-f
vanadium peroxide-f
Lead poisoning?
abdominal pain
anaemia
rasied erythrocyte protoporphyrins
and siderocytes
Mercury poisoning?
brown blue line on gums, fulminant itch, erethism- organic psychosis, cerebellar cortical atrophy, dislocation of the lens
cadmium poisoning?
focal emphysema
anosmia
renal calculi
glycosuria
chromium poisoning?
skin ulceration
asthma
pneumonitits
lung cancer
Manganese poisoning?
respiratory irritation
organic psychosis
parkinsonism
In solvent toxicology:
water soluble sovents penetrate the skin and accumulate in the nervous system?
false
fat soluble
In solvent toxicology:
All sovlents in a vapour form are rapidly absorbed into the lungs?
true
In solvent toxicology:
solvent volatility determines toxicity to an extent?
true
In solvent toxicology:
mixtures of solvents can cause biological competition and thus interfere with the action of each component?
true
Regarding chloronated hydrocarbons the following are correct:
Are inflammable and explosive?
false
non inflammable, non combustible, non explosive
Regarding chloronated hydrocarbons the following are correct:
used widely as degreasing agents, paint solvents and dry cleaning fluids?
true
Regarding chloronated hydrocarbons the following are correct:
the intro of the chlorine radical reduces their toxicity?
false
the reverse is true
Regarding chloronated hydrocarbons the following are correct:
as molecular weight falls so does toxicity?
false
as the molecular weight incrreases the toxicity increases
Regarding chloronated hydrocarbons the following are correct:
toxicity is related to volatility?
true
The following statements relating to carbon disulphide are correct:
It is the most common organic chemical that contains a carbon sulphidde group?
true
The following statements relating to carbon disulphide are correct:
skin absorption is the main route of entry?
false
inhalation is
The following statements relating to carbon disulphide are correct:
may be associated with infertility in males and females?
true
The following statements relating to carbon disulphide are correct:
only recently used in the synthetic fibre industry?
false
The following statements relating to carbon disulphide are correct:
Is a recognised multi system poison?
true
multi system poison
ihd, psychosis and parkinsons
Features of carbon tetrachloride are:
a colourless, volatile, non inflammatory, with sweet smelling odour?
true
Features of carbon tetrachloride are:
water soluble solvent?
false,
lipid soluble therefore pentrates skin
Features of carbon tetrachloride are:
nephrotoxic?
true
prinicipally affects prox tubules.
Features of carbon tetrachloride are:
the possibility of toxic effects is not affected by alcohol intake?
false
high alc synergistic effect on exposure
Features of carbon tetrachloride are:
liver complications are rare?
false
it is hepatotoxic causes liver necrosis
The following are true regarding tetrachloroethane:
it is a prescribed disease in the case of poisoning?
true
The following are true regarding tetrachloroethane:
widely used in general purpose solvents?
false
The following are true regarding tetrachloroethane:
poisoning associated with a toxic polyneuropathy?
true
The following are true regarding tetrachloroethane:
renal syndrome is recognised as an effect of chronic exposure?
false
a hepatic syndrome may lead to liver failure and death
The following are true regarding tetrachloroethane:
has teratogenic effects?
false
With regard to tetrachloroethene:
used in dry cleaning fluid and degrerasing agent?
true
With regard to tetrachloroethene:
not absorbed through the skin?
false
skin absorption does occur lung inhalation main route
With regard to tetrachloroethene:
prinicipal effect is CNS depression?
true
causes narcotic effects
With regard to tetrachloroethene:
gamma GT could be used in medical surveillance?
true
but need to r/o other causes
With regard to tetrachloroethene:
carcinogenic in workers chronically exposed?
false
In relation to methyl bromide the following are true:
it is generally a colourless odourless and sweet smelling?
false
In relation to methyl bromide the following are true:
acute exposure my be associated with convulsions?
true
In relation to methyl bromide the following are true:
chronic exposure may lead to hepatic failure principally?
In relation to methyl bromide the following are true:
get a dry scaly rash in excessive skin exposure?
false
get a characteristic erythematous vesicular rash
Trichloroethane (also called methyl chloroform):
is commonly known as trike?
false
trichloroethene
trichloroethane:
being phase out of industry?
true
trichloroethane:
used for degreasing of metals?
true
trichloroethane:
teratogenic?
false
trichloroethane:
Associated with fatalities?
true
inenclosed spaces
tetrachloroethene:
volatile and rapidly absorbed through the lungs?
true
tetrachloroethene:
can cause peripheral nerve damage?
false
causes cranial nerve damage
tetrachloroethene:
Is associated with a degreasers flush?
true
vasodilataion in response to drinking alcohol
tetrachloroethene:
is a severe skin irritant?
false
it is mild
tetrachloroethene:
may cause sudden death by ventricular fibrillation in a young adult?
true
this may occur after exposure following exertion
The following statements relating to solvent neurotoxicity are correct:
it is related to lipid solubility?
true
The following statements relating to solvent neurotoxicity are correct:
carbon disulphide can cause parkinson symptoms and poly neuropathies?
true
The following statements relating to solvent neurotoxicity are correct:
presenile dementia is a feature of styrene poisoning?
false
it is associated with white spirit
The following statements relating to solvent neurotoxicity are correct:
addiction to solvents is a possibility?
true
The following statements relating to solvent neurotoxicity are correct:
neurotoxic effects are largely reversible?
false
with regard to vinyl chloride the following are true:
it is a colourless gas used in synthesis of pvc?
true
with regard to vinyl chloride the following are true:
does not penetrate skin?
false
with regard to vinyl chloride the following are true:
is associated with scleroderma like changes?
true
affects hands and forearms
with regard to vinyl chloride the following are true:
acro-osteolysis at the distal ends of the long bones are sometimes found in workers who are chronically exposed?
false
affects distal phalanges of hands, causes pseudo clubbing
with regard to vinyl chloride the following are true:
angiosarcoma of liver can be a feature of chronic exposure?
true
In relation to nickel carbonyl the following are correct:
it is formed in the MOND process?
true
In relation to nickel carbonyl the following are correct:
highly toxic, colourless, volatile, rapidly absorbed via the lungs?
true
In relation to nickel carbonyl the following are correct:
in chronic poisoning raised levels of met- haemoglobin are found?
false
raised carboxy HB
In relation to nickel carbonyl the following are correct:
is a prescribed industrial disease?
true
In relation to nickel carbonyl the following are correct:
repeated exposure is associated with lung cancer?
false
may lead to asthma
The following are correct regarding hydrogen cyanide:
The toxicity residue in the cyanide radical?
true
The following are correct regarding hydrogen cyanide:
in poisoning the cytochrome oxidase is blocked and hence oxygen transport
false
oxygen transport not affected
The following are correct regarding hydrogen cyanide:
symptoms of poisoning are rapid onset and can be fatal?
true
headache
vomiting
excitability
convulsions
The following are correct regarding hydrogen cyanide:
Treatment can involve the use of oxygen and amyl nitrite casules?
true
The following are correct regarding hydrogen cyanide:
lactic acidosis is a prominent feature of poisoning?
true
With regards to pesticides the following are true:
is not covered by riddor?
false
With regards to pesticides the following are true:
neurotoxicity is a prominent feature of many insecticides?
true
it blocks nerve transmission
With regards to pesticides the following are true:
organochlorides persist in the environment for long periods?
true
with regard to pesticides the following are true:
organophosphates and carbamate groups inhibit acetylcholinesterase?
true
cause respiratory paralysis
The herbicide paraquate principally affects lungs?
true
rapidly absorbed by ingestion and specifically accumulates in lung tissue causing lung damage. Liver and renal faiure also.
medical and occupational rehabilitation should occur together?
true
Rehabilitation includes the following:
activities that help an individual return to former employment or to be redeployed with new skills
false
that is resettlement
Rehabilitation includes the following:
assessment of disability and employment handicap are the most important aspects in rehabilitation?
true
To allow a determination of functional recovery after injury or illness and hence whether a return to work/ redeployment is feasible
In back pain:
most are functional in origin?
false
most are mechanical
In back pain:
sleeplessness at night indicates a mechanical origin?
false
backache causing sleeplessness should be considered to be serious and malignancy ruled out
The following statements with regard to ill health retirement are correct:
it should be considered only when it is clear that an employees health problems prevent a return to previous employment?
true
but relocation could be an option
The following statements with regard to ill health retirement are correct:
an employer cannot dismiss an employee with a genuine health problem?
false
If an employee is unsatisfactory the cause of it may not be important. However established disciplinary procedures must be followed, retirement on ill health grounds could be an alternative option.
The following statements with regard to ill health retirement are correct:
the Occupational physician may recommend retirement if the working environment would continually affect the employees health adversely?
true
The following statements with regard to ill health retirement are correct:
the company medical officer is usually well placed to give advice?
true
He will know the tasks and the requirements in terms of fitness for the job
The following statements with regard to ill health retirement are correct:
It is the OH duty that redeployment has been considered before proceeding with the recommendation of retirement on ill health grounds?
true
Features of prolapsed intervertebral discs are:
L3 and L4 nerve roots are most commonly affected?
false
usually L5 and S1 nerve roots
Features of prolapsed intervertebral discs:
S1 radiculopathy causes loss of ankle jerk?
true
also causes sensory loss over lateral side of calf and foot
Features of prolapsed intervertebral discs:
L5 nerve root compression results in extensor plantar response?
false
there is a dropped foot and sensory loss over the shin and dorsum of the foot
features of prolapsed intervertebral discs:
include retention of urine?
true
due to cauda equina
Features of prolapsed intervertebral discs:
is made worse by valsalva manoeuvre?
true also coughing, straining, laughing
In vocational driving (LGV and PCV):
minimum vision standard for new applicants is 6/9 and 6/12 corrected?
true
and 3/60 uncorrected
with regard to occupational disease the following are correct:
information from the registrar of deaths gives good information?
false
open to incorrect/vague diagnoses by doctors and mis reporting of occupations by relatives.
working in confined spaces:
includes tanks, culverts, tunnels and trenches?
true
working in confined spaces:
may lead to some medical restrictions being imposed?
true
epilepsy
angina
vertigo
also blackouts, fainting, clasotrophobia, visual defects, severe respiratory disease or exertional dysponea.
working in confined spaces:
has lack of room to manouevre as the main hazard?
false
main problem is due to oxygen deficiency and build up of toxic gases
working in confined spaces:
can be carried out if well ventilated before entry?
true
or if not feasible wear breathing apparatus
Consideration of reproductive health in the workplace will include the following:
VDU work is commonly associated with miscarriage?
false
Consideration of reproductive health in the workplace will include the following:
physically strenuous work in females may lead to amenorrhea?
true
features of sick building syndrome:
lethargy and tiredness?
true
features of sick building syndrome:
equal sex distribution?
false more females
features of sick building syndrome:
migrainous headaches?
false
can cause headaches but not migraines
features of sick building syndrome:
influenza symptoms, asc with air conditioning systems?
true
seems to be more apparent when compared with naturally ventilated buildings
TB does not cause finger clubbing?
true
The following are associated with parkinsonism:
bradykinesia?
true
The following are associated with parkinsonism:
carbon monoxide poisoning?
true
it is a cause of secondary parkinsonism
The pregnant worker:
is suspended from work with lead?
true
occupational hygiene?
science and practice of protecting health persons at work by controlling their exposure to workplace hazards.
anticipitation
recognition
evaluation
control
risk
the likelihood of harm occuring in conditions of use of the substance
OES
occupational exposure standard
level to which employees can be exposed without harming their health
OEL occupational exposure limits
related to adequate control of substances by COSHH.
draeger tube
location sampling of gases and vapours
kata thermometer
air velocity
this is a liquid filled thermometer with a large silver bulb and a smaller bulb. It measures the cooling power of air and using a formula the air velocity is calculated
whirling hygrometer
measures air humidity
contains a wet and dry bulb the difference in readings used to calculate humidity of the air
a pump operated personal sampler?
sampling of gas vapour and dust
globe thermometer
radiant temperature
aibourne concentrations of dust
mg/m 3
vapour concentration in air
ppm
asbetos dust
fibres/ml
The following statements with regard to the aerodynamic diameter of particles are correct:
it is that of a theorhetical sphere of unit density with same air speed characteristics as a particle under investigation
true
ionising radiation
sievert
The following statements with regard to the aerodynamic diameter of particles are correct:
inhalable into the nose between 100micrometers and 1000 micrometers in diameter?
false
50-100micrometers
The following statements with regard to the aerodynamic diameter of particles are correct:
inhalable into bronchus and bronchioles between 25-50 micrometers ?
false
between 8-20 micrometers
The following statements with regard to the aerodynamic diameter of particles are correct:
inhalation into the alveoli is less than 7mirometers?
true
In fibres the length rather than the diameter determines the respirability?
false
control of exposure by ventilation:
is preferable to total enclosure?
false
total enclosure of a hazardous process is preferable to general ventilation
control of exposure by ventilation:
separates the worker from hazards by surrounding his breathing zone with good quality air?
true
control of exposure by ventilation:
uses dilution ventilation for substances with moderate to high toxicity?
false only suitable for substances with low toxicity
PPE
effectiveness of hearing protectors is defined in terms of assumed protection levels at the wearers ear to below Led'p of 90dB
risk assessment
is an examination of the workplace to see what could cause harm and what precautions need to prevent harm occurring
Risk assessment:
Needs to be carried out by a certified risk assessor?
false
can be done by safety officer or safety representative
Risk assessment:
written records?
true
if five or more employees
Risk assessment key steps
recognition
evaluation
control
review
In the properties of sound:
an octave band is a frequency interval where the top f is four times that of the bottom f?
false
the top f is double the bottom f
In the properties of sound:
the decibel scale is a logarithmic scale of sound frequency?
false
it is a logarithmic scale of sound intensity
In the properties of sound:
a 10 db increase represents a sound twice as loud?
true
In the properties of sound:
a three decibel increase in noise level results in halving the allowable exposure time?
true
known as the three decibel rule
In noise induced hearing loss:
a familial type of hearing loss may cause a 4kHz dip?
true
an autosomal dominant hearing loss in the range 3KHz to 6KHZ
In noise induced hearing loss:
the characteristics of the noise are important?
true
impact noise may affect 6KHz more than other frequencies. The maximum effect of a single frequency noise is usually one half of an octave band above the frequency.
In noise induced hearing loss:
individual variation or susceptibility does not apply?
false
In noise induced hearing loss:
duration of exposure is important ?
true
dB (A)
noise weighting that closely simulates the human ear
Lep'd
level of daily continual exposure
it is used to represent personal exposure over an eight hour period.
2nd action level
hearing protection mandatory
Lep'd of 90dB (A) the level below which noise should be reduced if possible
noise dose
depends on level of noise and exposure time
peak action level
140dB
In occupational deafness:
there is a classical 2kHZ dip?
false
it is a four kHZ dip
In occupational deafness:
pure tone audiometry is used for assessment?
true
the subject should not have been exposed to loud noise for up to twelve hours before the test
In occupational deafness:
A loss of 50 dB in each ear is a prescribed disease?
true
In occupational deafness:
tinnitus is an early warning sign?
false
it is a late sign
A hearing conservation programme involves:
a noise survey and designation of hearing protection zones?
true
A hearing conservation programme involves:
total enclosure of all sounds greater than 90dB?
false
90dB is the second action level ( noise at work regs 1989) and hearing protection is mandatory at these levels
Associated with sensorineural deafness?
rubella
acoustic neuroma
otosclerosis, pagets--> false CONDUCTIVE DEAFNESS
Vibration:
is measured in terms of frequency and acceleration?
true
vibration:
is covered by the EU physical agents directive?
true
vibration:
has a critical range for segmental vibration of 8-1400HZ?
true
Hand arm vibration syndrome:
is a chronic progressive disorder with a latent period of 1-15years?
true
HAVs:
Is a prescribed industrial disease?
false
vibration white finger is a prescribed industrial disease
HAVs:
causes damage to the digital nerves and arteries?
true
there is occlusion of the proximal segment of the digital arteries which reduces the size of the lumen
HAVs:
is classified with which scale?
stockholm scale
The differential diagnoses of HAVs:
primary raynauds
costoclavicle syndrome
SLE
carpal tunnel syndrome
In the managment of HAVs the following are correct:
each hand is assessed separately?
true
In the managment of HAVs the following are correct:
doppler finger blood flow tests are diagnostic?
false
these can be done but it is not diagnostic
In the managment of HAVs the following are correct:
stellate ganglion blocks are a first line treatment?
false
In the managment of HAVs the following are correct:
cold and smoking should be avoided?
true
light- visibility of a task depends on:
luminance of the task?
true
light- visibility of a task depends on: visual fringing?
false
light- visibility of a task depends on: contrast?
true
light- visibility of a task depends on: colour flickering?
false
Illuminance
the intensity of light falling on a surface, measured in lux which is lumen per m2
luminous intensity?
power of source to emit light units candela
luminance
the physical brightness of a surface, measured in candela per m2
Reflectance?
luminous flux reflected: luminous flux incident
luminous flux
the light emitted by a source or recieved by a surface
Beta particles?
can penetrate the skin to 1cm and are hazardous to superficial tissue.
radioactivity?
spontaneous process of decay
gamma rays?
very penetrative and hazardous
alpha particles ?
positively charged
cannot penetrate the skin
not a significant hazard
The following statements with regard to ionizing radiation are correct:
tissues with rapidly developing cells are most sensitive?
true
lymphocytes, gonads, bone marrow, epidermis, intestine lining
An example of a stochastic effect is a cataract?
false
stochastic effects are those such as carcinogenesis and genetic damage.
The following statements with regard to ioninsing radiation are correct:
deterministic effects vary according to dose?
true
also known as non-stochastic
e.g. acute radiation syndrome
The following statements with regard to ioninsing radiation are correct:
statutory dose limits are to prevent stochastic effects?
false
limits are set to prevent non-stochastic effects as they have a threshold.
A sievert is a unit of dose equivalence?
true
the absorbed dose in grays multiplied by a factor to take account of the type of radiation ( the factor is known as the relative biological effectiveness)
The following statements with regard to ioninsing radiation are correct:
acute radiation syndrome develops following whole body irradiation of two sieverts or more?
true
in a single dose or over a short period
The following statements with regard to ioninsing radiation are correct:
background radiation is about 10mSv per year?
false
in uk it is 1mSv per year
The following statements with regard to ioninsing radiation are correct:
threshold for skin damage is 3sv acute or 0.5sv per year?
true
The following statements with regard to ioninsing radiation are correct:
ICRP dose limits for pregnant women is 10msv per year?
true
furthermore for women of child reporductive capacity the abdominal dose is 13msv in any consecutive 3 month period
The following statements with regard to ioninsing radiation are correct:
classified workers are those liable to recieve in excess of three tenths of the annual dose limit?
true
Features of ultraviolet radiation are:
divided into two wavelengths?
false
three wavelengths: UV (A) 315-400nm,
UV (B) 280-315nm, UV (C) 100-280nm
UV(C) is mostly absorbed in the atmosphere
Features of ultraviolet radiation are:
UV (A) produces serious side effects on the skin and cornea?
false
UV(B) is associated with photokeratitis of the arc eye. Most of the UV (B) is filtered by the cornea.
Features of ultraviolet radiation are:
over exposure may lead to cataract formation?
true
usually associated with UV (A) as most of this is absorbed in the lens
Features of ultraviolet radiation are:
UV(B) is associated with snow blindness?
true
Features of infrared radiation are:
three wavelengths?
true IRA 760-1400nm, IVB 1400-3000nm, IRC 300nm-1mm
Features of infrared radiation are: severe skin burns?
false
skin can burn but relatively slowly
Features of infrared radiation are:
can cause injury to the lens and retina?
true
causing cataract formation
Features of infrared radiation are:
IRA is normally visible?
false
Features of infrared radiation are:
a recognised hazard in glass blowing?
true
glass blowing cataract
Features of microwave radiation:
it is at the high end of the EM spectrum?
false
it is at the low end
1nm to 1m
Features of microwave radiation: it is linked to eye damage?
true
cataracts
Features of microwave radiation: pulsed waves are more damaging than continuous?
true
Features of microwave radiation: carcinogenicity in humans?
false
The following statements with regards to lasers are correct:
they emit light of different wavelengths depending on the type of laser?
true
The following statements with regards to lasers are correct:
it is safe to view their reflection without the need for eye protection?
false
reflections of class 1-3 ok 4 no
The following statements with regards to lasers are correct: main risk is cataracts?
false
main risk retinal burns
convection
depends on air temperature and velocity
thermoregulatory mechanisms?
perioheral vasodilation and sweating
radiation
does not depend on air movement
evaporation
dependent on temperature humidity and air velocity
treatment of heat stroke involves slow cooling?
false
involves rapid cooling
compressed air and diving-
The following statments with regard to decompression sickness are correct:
only occurs in workers exposed to helium at high pressures?
false
can occur in anyone exposed to air or any other gas at increased pressures.
compressed air and diving-The following statments with regard to decompression sickness are correct:
niggles and bends are example of type 1 symptoms?
true
type 1 symptoms are mainly peripheral effects
niggles- pleuritis and limb discomfort
bends- extreme limb pain and both exhibit skin mottling
compressed air and diving-The following statments with regard to decompression sickness are correct:
chokes and staggers are related to type 2 symptoms?
true
type 2 symptoms - generalised and severe, chokes relate to dysponea and staggers relate to vertigo
compressed air and diving-The following statments with regard to decompression sickness are correct:
aseptic bone necrosis occurs at the proximal end of the phalanges?
false
thought to be due to infarction of nitrogen emboli in the arterial vessels of the bone, the distal end of the femur, prox tibia and humerus are common sites
compressed air and diving-The following statments with regard to decompression sickness are correct:
incidence is about 10-12% of all decompression?
false, incidence varies from less than 1-2% of total decompressions. The majority are type 1 less severe.
In medical assessment for diving:
a certificate for fitness in diving how often?
annually
In medical assessment for diving: peptic ulcers, hernias and obesity are deterents to employment?
true
In medical assessment for diving:personal medical records are held by the diver?
true
In medical assessment for diving: a dental assessment is important?
true
air entrapment in the dental caries
In medical assessment for diving: assessments are laid down by COSHH?
false
laid down by medical code of practice for work in compressed air and diving operations at work regulations 1981