162

ISBN : 978-974-297-965-2
1 : 2553
2 : 2555

500
11,000

. 02-5918172, 02-5904514, 02-5918381
02-5904388, 02-5918381
E-MAIL : MEDIA.ENVOCC@GMAIL.COM

:

(.)





1 ........................................................................... 1
2 ................................................. 4
3 .......................................................................... 8

3.1 ................................................................................ 8

3.2 .................................................................................. 12

3.2.1 ...................... 13

3.2.2 ....................... 15

3.2.3 ............................................ 17

3.2.4 .............................................................. 18

3.3 ..... 19

3.3.1 ............................ 22

3.3.2 ............................................................. 28

3.3.3 .................................................................... 33

3.3.4 ................................ 45

3.4 .................................................................................................................... 50

3.4.1 ....................................................................................... 50

3.4.2 ............................................................................................... 54

3.4.3 .............................................................................. 54

3.4.4 ....................................................................................... 56

3.4.5 ..................................................................... 58

3.4.6 ..... 61

3.5 .................................................................................... 62

3.5.1 .............................................................................................................. 62

3.5.2 ............................................................................................................. 64

3.5.3 ..................................................................................................................... 65

 ()




3.5.4 ......................................................................................... 66

3.5.5 ........................................................................................... 67

3.5.6 ........................................................................................... 67

3.5.7 ....................................................................................................... 68

3.5.8 ........................................................................................................ 69

3.5.9 ............................................................................................................... 71

3.5.10 ............................................................................................................. 72

3.5.11 ................................................................................................. 72

3.5.12 ()................................................................................. 73

3.5.13 ....................................... 74

3.5.14 ................................................................................................................ 75
4 ............................................................... 77

4.1 ........................................... 77

4.2 ...................................................................................................... 82

4.3 ..................................................................... 85

4.4 ............................................. 94

4.5 ........................................................................... 101

4.6 ................................................................................ 104
5 ............................. 119
6 .................................................................... 137
.................................................................................................................................................... 143
(Glossary)........................................................................................................................ 147

3.1
7 15 .............................................. 19
3.2 /................................................................................................ 55
3.3 /...................................... 60
4.1 .................................................................................................... 82
4.2 ............................................................... 93
4.3 ........ 101
4.4 .................. 104
4.5
....................................................................... 105
4.6 ........................ 105
4.7 UMN LMN........................................ 106
4.8 ....... 109
4.9 ......................................................................... 114
4.10 ......................................... 115
4.11 ........ 117
5.1 ...................... 121
5.2 /........... 124

3.1
................................................................ 34
3.2 Finkelsteins test................................................................................................................ 35
3.3
........................................................................................ 36
3.4 .................................................................... 37
3.5 .................................................................... 39
3.6 ......................................................... 40
3.7 ............................... 41
3.8
.................................................................... 41
3.9 Ballottement..................................................................................................... 42
3.10 McMurrey test
internal and external rotation ..................... 43
3.11 Apley test
internal and external rotation ............... 43
3.12 modified Phalens test............................................................................... 45
3.13 ........................................................................................... 47



1



2




3











4

 5





6

16-60 .. 2550

7,244 9

506/2 1985
1 1452
20 31 133 118
1 231 62,933,515
.. 2550

198,652

9,000

16 137
50.8

1.


2.



3.

4.

5.

1.

2.

3. (Cluster of disease)

4.

5.

6.

7.



8.

1. ? ? ?

15

2. ?

3. ?

4.

5. ?

1. (occupational disease)

2. (work-related disease)

15

3-6 3

10-20

.. 2543


1.

50

2.

3.

()

4.

5.


6.

1.

2.

3.

4.
506/2

3.1

2 3
90
(Occupational Diseases)
(Work-Related Diseases)

()

(Occupational accident)

(ILO) ..1996


1) (fatal occupational injury)

2) (non-fatal occupational injury)




1. (commuting accident)


1)

2)


3)


2. (dangerous occurrence)



3. (incident)

10

1.
(wound)
(fracture) (burn)

2.

2

1. (acute injury)


1.1 (trauma)

(wound) (fracture)
(amputation)

1.2 (burn)


2. (chronic injury)

(musculo-skeletal)

1.
-

11

-


-





-


-


2.

-



-


-

-


-


-

-


- (
)

12

3.2

45

.. 2549 24.39



1. 80

2.

3.

4.

13

3.2.1

1.
6.

2.

7.

3.


8.

4.
9.

5.

10.











2

1.

2. 2-8






1.

14

2.
3.
4.
5.
6.

()

Patch test


1.

2.

2.1 (wet compress) (Burrow solution)
10-15 2-3
2-3

2.2
2-3 0.1% TA 0.1% Bet 0.02% TA
3% SA in 0.1% TA

3.

3.1 Chlorpheniramine, Hydroxyzine

3.2
15-20 2-3 7-10

4.

4.1

4.1.1
(low allergenic properties)

4.1.2

4.1.3

4.2
Vanishing cream

15

3.2.2

1.


6.

2.

7.

3.
8.

4.

9.

5.

10.

















eczema 3

1.

2.

3.

16

1.

2.

3.

4.

5.

()

Patch test




1.

2.

2.1 (wet compress) (Burrow solution)
10-15 2-3
2-3

2.2
2-3 0.1% TA 0.1% Bet 0.02% TA
3% SA in 0.1% TA

3.

3.1 Chlorpheniramine, Hydroxyzine

3.2
15-20 2-3 7-10

4.

4.1

4.1.1
(low allergenic properties)

4.1.2

4.1.3

4.2
Vanishing cream

3.2.3

17

20-30 1
24

1.

2.

3.

4.

5. Penivillin Cephalosporins

1
shock
eczema


1.

2.

3.

4. 20-30 ( 1 )

5.

6.


1. (prick test)

2. (provocative
test)

18

1.

2.

2.1 Chlorpheniramine, Hydroxyzine, Cetrizine
Loratadine

2.2

3.2.4

after lotion

1-2

2



1.

2.

3.


1.

2.

3.

19

3.3

15
54.2
25.0 ()
26.3 (myofacial pain syndrome) 17.0
3.1

3.1 7

15 ( 264
7 685 )

(low back pain)

54.2

(tendonitis)

25.0

(myofacial pain syndrome)

17.0

(osteoarthritis)

17.0

Arthralgia (work-related overuse)
(c-spondylosis)

4.9

(gout & pseudogout)

1.4

(rheumatoid arthritis)

0.75

(spondyloarthropathies)

0.75

(SLE)

0.38

1.5

20

(myofacial pain)
(fibromyalgia)

()

194 (R194) ..2547

1.

2.


3.

21

4.

5.


6.


7.

8.

1 7

1

2

22

3

4
(myofacial pain) (fibromyalgia)

3.3.1

60-80

(coccyx)

/


1-2






3

1.

80-90%
2-3

23

2.

reflex

3.




2

1. (mechanical
back pain)

1.1 (sprain and/or strain)

1.2 (herniated intervertebral disc)

1.3 (degenerative joint disease osteoarthritis spondylolysis
spondylolisthesis)

1.4 (spinal stenosis)

1.5 (Vertebral fracture, compression fracture)

2.

2.1

2.1.1 (vertebral osteomyelitis)

2.1.2 (discitis)

2.1.3 (pyomyositis)

2.1.4 (pyogenic sacroiliitis)

2.1.5 (epidural abscess)

24

2.2 (spondyloarthropaty)

2.2.1 (ankylosing spondylitis)

2.2.2 (psoriatic arthritis)

2.2.3

2.2.4

2.3

2.4

2.5

2.5.1 (osteoporosis)

2.5.2 (pagets disease)

2.5.3 (myofacial pain)
(fibromyalgia)

2.6

2.6.1 (back muscle strain sprain)

(back muscle spasm)

2.6.2 (herniated disc)

(annulus fibrosus)
(annulus fibrosus)
(nucleus pulposus)
(posterior longitudinal ligament)

25

(nucleus pulposus)

(root pain sciatica)
L4 L5

40-60 (straight leg raising test)

(deep tendon reflex)

(CT Scan)
(MRI)

2.6.3 (primary degenerative
disease of the spine)

()
(osteophyte)
(joint space narrowing)
(annulus fibrosus)

2.6.4 (Spinal Stenosis)

(spinal canel)

(osteophyte)
(ligament)

26

2.6.5 (osteoporosis)

(vertebral compression fracture)

(red flags)

1.
(immunocompromized host)

2. ( )

3.
(aortic aneurysm/dissection)
(rupture of hollow viscus)

4.


5.


6.


7.

(claudication)

(spinal stenosis)

27

8. (morning stiffness)
30

9.

10. /
(saddle paresthesia)

11. 2




CBC, UA, Stool exam, stool occult blood, blood chemistry

red flags






1.

2.

- 20 55

- +

- +

- +

- DM HT CA HIV

-

-

-

28

-
-

(psychological)

red flags /

3.3.2

. 2551
10

1.


2.

(arthralgia) (arthritis) (arthritis)

29

1.

1.1 -

(crystal induced arthritis)
(pseudogout)

1.2

1.3




1.4 ( )



1.5 ( 6 )



1.6

(migratory pain)

1.7




1.8





1.9

30

1.10

1.10.1 (Diuretics)

1.10.2 ethambutol pyrazinamide


1.11



1.12



2.

2.1 (arthritis)
(arthralgia)

2.2

2.2.1 (active movement)

2.2.2 (passive movement)

2.3

2.3.1 (acticular paint) :
active passive movement

2.3.2 (periarticular pain) :



2.3.3 (non-articular pain)
(referred pain)

2.3.4

31

3.
3.1 (acticular paint)

3.1.1 (acute, monoarthritis)


- GC non GC


- crystal induced arthritis (gout pseudogout)


- traumatic arthritis


-


- rheumatoid arthritis

crystal induced arthritis

3.1.2 (chronic, monoarthritis) ( 6 )


-


-


- osteoarthritis


- spondyloarthropathies, monoarticular, rtheumatoid arthritis



3.1.3 (acute, polyarthritis)


-


- crystal induced arthritis (gout, pseudogout)


- spondyloarthropathies


- SLE rtheumatoid arthritis connective tissues


-


crystal induced arthritis

32

3.1.4 (chronic, polyarthrtis) ( 6 )
(symmetrical)


- RA


- CNT disease : SLE, systemic sclerosis, polymyositis, etc.


- hematologic/solid organ tumor


- infection related : infective endocarditis


(asymmetrical)


- spondyloarthropathies group


- reactive arthritis/reiters syndrome


- ankylosing spondylitis


- associated inflammatory bowel disease



3.2 (pariarticular pain) bursitis


-

-
(NSAIDs)

-
3.3 (non-articular pain)
(referred pain)


-

33

3.3.3

2









1. (radius)

2.

3.

4.

5.


6.


7.

34

1.

de Quervains tendonitis
/







1.



2.



3.

( 3.1)








3.1

35

4. Finkelsteins test








3.2 Finkelsteins test





(SLE)



2.
(trigger finger)
/

36

1.


2.

3.

4. ( 3.3)

5.

6. (CTS),
Amyloidosis, Mucopolysaccharidosis,

















3.3

37

3.
/

3.4
( : hhhp://www.apmsurgery.com/Dlagnoses/Bursitis.html)

38

4.
/

1.

2.

3.

39

3.5
( : hhtp://www.uwec.edu/KIN/majors/AT/aidil/images/prepatellarbursa2.jpg)





1.

-

-

-

-

-


2.





-
()


-

-

40

5.
(tennis/golfer elbow)
/
















3.6

41

3.7

3.8




1.

2.

42

6.

/

2 30
1

(antalgic gait)

1.
Ballottement Pateller tapping test Fluid shift test






3.9 Ballottement

43

2.

3.
McMurrey test. Apley test







3.10 McMurrey test internal and
external rotation
( : http://www.mhhe.com/hper/physed/athletictraining/illustrations/ch20/20-24.jpg)







3.11 Apley test internal and external
rotation
( : http://www.mhhe.com/hper/physed/athletictraining/illustrations/ch20/20-25.jpg)


4.

44

7.
/

1.


3-4 1 2
5 40
6

2. 45

2

1.


2.

45

1.


2. 30

2
2 30

3.12 modified Phalens test

3.

-

-


-

-


3.3.4

2
(myofacial pain)
(fibromyalgia)

46

4.1
(fibromyalgia)

4-7



1. 3

2.


3.


4.

-

-

-

- (morning stiffness)

-

-
( ACR-The American College of Rheumatology 1990)

1. 3
4
2.

11 18



18 3

4 (
) 1

47

( )

- (forehead) (right mid forearm)


1, 2 Occiput
: subocciput muscle insertion
3,4 Low cervical
: anterior aspects intertransverse spaces at C5-C7
5,6 Trapezius
: Mid point of the upper trapezius muscle border
7,8 Supraspinatus
: Origin scapular spine
9,10 Second rib
: lateral 2 cm. from costochondral junction , 2nd rib
11,12 Lateral epicondyle : 2 cm distal to the epicondyle
13,14 Gluteal
: Outer upper quadrant of buttock
15,16 Greater trochanter : posterior to the trochanteric prominence
17,18 Knee
: medial fat pad proximal to the joint line and condyle







3.13
( : http://www.chiro.org/LINKS/Fibromyalgia.shtml)



1.

1.1


1.2

48

1.3

2.

2.1 Tricyclic antidepressant Amitriptyline 10-35 .

2.2 Selective serotonin reuptake inhibitors (SSRI) Fluroxetine
5-10 . 20 .

2.3 Tramadol hydeochloride 50-400 .

4.2 (myofascial pain syndrome)










systemic
symptom

49

:

1.

2. (trigger point)
1
(fibromyalgia)

3.
(dermatome)


1.

2.

2.1 (trigger points)

2.1.1

2.1.2 ultrasound

2.1.3

2.1.4

2.1.5 (trigger point)

2.1.6

(transcutaneous electrical nerve stimulation)

2.1.7

2.2

2.2.1

2.2.2

2.2.3


(myofascial pain syndrome)
(fibromyalgia)
(multiple
complaint)

50

3.4

6

1.
/

2.

3.

4.

5. (toxic pneumonitis)
(inhalationfever)

6. (Allergic
and irritant rhinitis)

3.4.1




(silica)
(asbestos)


(beryllium)

(silicosis)
(asbestosis)

(coal workers pneumoconiosis)
(beryllosis)
(siderosis)
(stannosis)
(baritosis)

51

3.4.1.1 (silicosis)

/

1.

2.

3.

4.

5. (sand blasting)

6.

7.

8.
/


5-15



5



1. ILO-2000

2. (high resolution CT scan)


1. 1

2. 1

52

3.4.1.2 (asbestosis)



/

1.

2.

3.

4.
/





1. ILO-2000

2. (high resolution CT scan)


1. 1

2. 1

3.4.1.3 (coal workers pneumoconiosis)

/


/





1. ILO-2000

2. (high resolution CT scan)

53

1. 1

2. 1

3.4.1.4



/

1.

2.

3.

4.

5.







1. ILO-2000

2. (high resolution CT scan)

3.


1. 3

2.

3. 1

4. 1

54

3.4.2 (byssinosis)


/

1.

2.

3.

4.

4
1

1.
2


2. 1


3. 2

4. 3 2







2
3.4.3

55

3.2 /

1.



(latex)



2.

/
-

-
-
-
- ()
-
- ()
-
-
-
-

-

-
-

10-30
3-8

56

24


1. spirometer

2. peak respiratory flow meter 2

1 paek espiratory flow rate (PEFR)

20%

3. methacholine challenge test

4. specific bronchial challenge test

:

1. 2

2.

3.


4.

5.
:

5
3.4.4 (hypersensitivity pneumonitis)

(antigen)

57

/

1.

2.

3.

4.

5.

6.

7.

8.


9.

10.

11.

12.


2-9

1.

2. (high resolution CT scan)

3.


1. /

2.

58

3.4.5 (toxic pneumonitis)

2 (inhalation fever)
(chemical pneumonitis)
3.4.5.1 (inhalation fever)
1. (metal fume fever)



/

1.

2.

3.

4.


4-12

39-40 C
48


CBC

PMN (polymorphonuclear leukocyte)

1. 72

2. 72 506/2
2. (organic dust toxic
syndrome)


(endotoxin) (mycotoxin)

59

/

1.

2.

3.

4.

5.

6. /

4-12

39-40 C
48


CBC

PMN (polymorphonuclear leukocyte)

1. 72

2. 72 506/2
3.4.5.2 (acute chemical pneumonitis)

60

3.3 /

:




hardener epoxy resins
isocyanates

( )

(stridor)

61

3.4.6
(Allergic and irritant rhinitis)

( ) (

)






/

1.

2.

3.

4.

5.

6.

7. (electroplating)





1.

2. (skon prick test)

3. nasal peak flow meter rhinomanometry


1. /

2.

3.

62

3.5

(Silicotuberculosis)

()




3.5.1


( )
()






-

-

-

63

7-10

(1-5 )

(1-3 )
( )
24-36

-

-

-

-


( 500 2

100 2 60 )

64

3.5.2

()

- /

-

-


100 2 600-900

65

3.5.3

()



(
)


5-14
2 () 4-7


()
1 1-2
biphasic

66

100 2 7




3.5.4

2-3

67

3.5.5



2-3 ()
()

Hepatocellular carcinoma

(HBs Antigen)






3.5.6

68

() ()
Hepatocellular carcinoma












3.5.7

69

80

-

-

-


( 100 2

500 4 500 6
10-14 )



3.5.8








-

70

-


-

( )


2-6



() ()
()

1.

2.

3.

71

3.5.9

(lockjaw)











10,000-20,000
3000-6000

()

72

3.5.10

(

)

4-6



3.5.11 (silicotuberculosis)


()

73

3.5.12 ()

74

( 1-2 / 2
7-14 5-7 100 2
14 )



3.5.13

3-7

2-3

65


(38 )

-

10

75

- 10

- ()





(respirator)

3.5.14

H5N1

3-7

76

( )


(respirator)

77

4.1

1.

78

1.1

(angina pectoris)

2-3
(nitroglycerine)

(methylene chloride)
(carbon disulphide)
(organic nitro-compounds) (lead) (hydrocarbons)
(halogenated hydrocarbons)

(vasospastic angina)
(prinz metal angina)
(nonatheromatous ischemic heart disease)
(organic ntrates)
(ethylene glycol dinitrate)

1.2

(pericardial friction rub)


(antimony) (arsine)
(cobalt)

79

1.3
(dissecting aortic aneurysm)




1.4 (acute pulmonary infarction)

(pleuritic)

(deep vein thrombosis)


1.5
(costochondritis)

1.6

1.7 (referred pain)

2.


(pulmonary congestion)


2.1
(dilated cardiomyopathy)

80

2.2

(hypertrophic cardiomyopathy)

2.3
(myxoma)

2.4
(leftsided heart failure)


2.4.1

2.4.2


2.4.3 1-2 .


2.4.4 (cardiac asthma)


3.

(chlorofluorocarbon)
(1,1,1-trichloroethane)
(trichloroethylene)

4.
(cardiac output)

4.1

4.2

81

4.3 (vagovagal syncope)

tilt table test

4.4

4-5 10-20


5. (cyanosis)
(peripheral cyanosis)


(central cyanosis)
(reduced hemoglobin) (methemoglobin)
(methemoglobinemia)





(sulfhemoglobinemia)

(10% potassium cyanide)

(aniline)
(methylene biphenyl isocyanate, MBI) : (nitroaniline)
(toluidine) : (p-chloroaniline)

82

: o-toluidine
(trypanblue stain) : (naphthalene)
(paradichlorobenzene)

: (nitrates) (potassium chlorate)

: (nitrous gases) :

(trinitrotoluene)

4.2

4.1

4.1



1. ()
airway



-

(organic solvents)

airway



-


(organic solvents)

83

-

400

2.
(dyspnea on exertion)

-


(silicosis)

-

(pneumoconiosis)
(asbestosis)
(silicosis)
(mesothelioma)

84

3.
1

(acute pneumonitis)

()

(chlorine)
(SO2)

4. -

(paranasal

sinus)
(sinonasal sinus)

()

(Nickel)
(Chromate)

5. - Pumonary edema
(pink (xylene)
frothy sputum) (cadmium)
(SO 2) (ozone)
delayed pulmonary
edema

6. (anoxia) -

(simple asphyxiants).

chemical
asphyxiants

85

7. -
(Respiratory failure)
neuromuscular Junction ;
NMJ (organophosphate)

(rapid massive fibrosis)

(bipyridyls
paraquat, diquat)

4.3

1.


2.

86

(Tetrachloroethylene)


(achalasia) (peptic esophagitis)


(reflux)


3.

3.1

3.1.1

3.1.2

3.1.3

3.1.4

3.1.5

87

3.1.6

3.1.7

3.2

3.2.1

3.2.2

(Addisons disease)

3.2.3

3.2.4

3.2.5 (digitalis) (sulfonamides)

3.3
(labyrinthine disorder)

3.4

4.
(colic)

4.1

4.1.1 (parietal peritoneum)


1)

2)

88

4.1.2


1)


2)

4.1.3


1) (embolism)

(thrombus)


2)


3)


4)

(sickle cell anemia)

4.1.4


1)


2)


3)

4.2

4.2.1

4.2.2

4.2.3

4.3

4.3.1 (uremia)

4.3.2 (diabetic

coma)

4.3.3 (porphyrias)

(heme biosynthesis)

colic

89

(hexachlorobenzene)

(2, 4-dichlorophenol)

(2,4,5-trichlorophenol)

(2,3,7,8-tetrachlorodibenzo-p-dioxin)

(o-benzyl-p-chlorophenol)

(2-benzyl-p-dichiorophenol)

4.4 (organic)

(functional)

5. (dyspepsia)

10-30% 15-25%
(scleroderma)
(theophylline) (digitalis)
(erythromycin)

(circadian rhythms)

90

6.

3 3
3

3 2



6.1

1)

2) (aganglionosis) (Hirschsprungs

disease)

(megacolon)

3)

4)

6.2

1)

2)

(aluminium hydroxide) (calcium

carbonate) (opiates)


(multiple myeloma) (chronic leukemia of
differentiated B cells plasma cell leukemia)

91

3)

4)

(cauda equine) (tabes dorsalis)

(dorsal root

ganglion)

5)

6.3

1)

2)

7.

(bismuth)


7.1

7.2

(trinitrotoluene,

TNT) (polychlorinated biphenyls,PCBs)

(tetrachloroethane), (chlornaphthalenes)

(carbonatetrachloride)

(trichloroethylene) (1,1,1-trichloroethane)

7.3

7.4 (Mallory Weiss syndrome)

(mucosa) (submucosa)

(cardia)

92

7.5

(idiopathic thrombocytopenic purpura,ITP)

7.6

7.7 (uremia)

8. (jaundice)


3

8.1

(prehepatic total serum bilirubin)

(total bilirubin)

6 / (indirect bilirubin)

(phenylhydrazine)

8.2 (hepatocellular)

(carbon tetrachloride), (chloroform)
(trinitrotoluene) (phosphorus) (dimethyl
formamide) (hydrazine)

8.3 (cholestatic)

(methylene dianiline) rapeseed oil

93

( cholestatic)
( cholestatic) (postnecrotic cirrhosis; cholestatic)
(chlorpromazine) (chlorpropamide)
(methyltestosterone) (erythromycin stolate not
stearate)


(choledochol cyst)

(chronic active hepatitis)

(halothane)

4.2

4.2

/
(hepatocellular/cytotoxic)

(necrosis)

(zonal)

(halogenated
hydrocarbon)
(carbon tetrachloride)
(chloroform) (methyl

chloride)
(trinitrotoluene)

(massive)
(steatosis)

(phosphorus) (dimethyl

formamide) (hydrazine)

94

(cholestatic)

(methylene dianiline)

(cirrhosis)

(polychlorinated biphenyl)
(tetrachloroethane)

(sclrosis)

(steatosis)

(granuloma) (beryllium)

(porphyria)

(dioxin)

4.4

4.4.1 2-3

(naphthylamine) (4-aminobiphenyl)

(benzidine) (chlornaphazine)

(4-chloro-o-toluidine)
(o-toluidine) (4, 4-methyiene bis 2-

95

chloroaniline) (methylene dianiline)

(benzidine-derived azo dye)
(phenacetin-containing compounds)

2-3 (nephrotic syndrome)

(solutes)

4.4.2

4.4.3

4.4.4 3

96

1.

( solute load)

2. (solute diuresis)

(water diuresis)

4.4.5
5 / high power field ()

(urate) (phosphate) (chyuria)

(glomerulonephritis)

(interstitial nephritis)

4.4.6

(macroscopic hematuria)

3-5 / high power field

() (microscopic
hematuria)

97

1.5

(red blood cell cast) (phase

contrast microcope) (dysmorphic red blood cell)

(glomeruli)
(glomerulonephritis) (lgA nephropathy)
(interstitial
nephritis)

4.4.7 (hemoglobinuria)

(oxyhemoglobin)
(methemoglobin)
(reduced hemoglobin)

(hemosiderin)

(ferric ion)

(renal tubule)

(urobilinogen) (myoglobin) (porphyria)
(alkaptonuria) (melanuria) (beet)

(dipstick) (heme, orthotolidine)

(melanuria) (beet)

(dipstick) (heme, orthotolidine)

98

4.4.8 (myoglobinuria)

(heat stroke)





(radioimmunoassay)

(acute tubular necrosis)

4.4.9 150 .
3

1. (transient/functional proteinuria)

(adrenalin)

2. (orthostatic proteinuria)

3. (constant proteinuria)

24

1.5 (tubular
proteinuria) (globulin)
(tubule)

1.5 (glomerular proteinuria)

99

3.5




4.4.10

(trinitrotoluene,TNT) (polychlorinated biphenyls, PCBs)

(tetrachloroethane) (chlornaphthalenes)
(carbonate trachloride) (trichloroethylene)

(1, 1, 1-trichloroethanej)

(dependent)

(silicosis) (asbestosis)

100

(byssinosis) (farmers lung disease)

(baagassosis)

4.4.11 400

4.4.12 100
(renal
infraction) (renal vein thrombosis)

(acute glomerulonephritis) (acute

tubular necrosis) (cortical necrosis)
(papillary necrosis)

(halogenated hydrocarbons)
(carbon tetrachloride) (ethylene dichloride) (chloroform)
(trichloroethylene) (tetrachloroethane)
(vinylidene chloride) (ethylene chlorohydrin)

(non-halogenated hydrocarbon)

(dioxane) (toluene) (ethylene

glycol) (phenol) (pentachlorophenol)
(dinitriphenols) (dinitro-o-cresols)

101

4.3

-
-
- (heat stoke)

(oxalic acid)
(tartrates)
(ethylene glycol)
(carbon tetrachloride)
(tetrachloro ethane)

-
-
:

(carbon disulfide)
(halogenated hydrocarbons) :
(chlorotrifluoroethylene) (hexafluoropropane)
(hexachlorobutadiene) (trichloroethylene) (chloroform)
(carbon tetrachloride) (silicosis)

4.5

4.5.1



1.

1.1

(pure red cell aplasia)

(aplastic anemia)

102

(pancytopenia)

(cytotoxic

drugs) (antimetabolites)

(alkylating agents)

(trinitrotoluene, TNT) :

(hexachlorocyclohexane, lindane)

(pentachlorophenol)

(chlorophenol, DDT) :

: (ethylene glycol

monomethyl) (monobutyl ether)

(myelodysplastic syndrome, MDS)

103

1.2

(multiple myeloma)

(butadiene) (styrene) -

(ethylene oxide)

1.3

12

(megaloblastic

anemia)

2.

(copper sulfate)

(hereditary spherocytosis)
(autoimmune hemolytic anemia)


3.


4.
(petechia)

4.4

104

4.4

(immune)
(toluene diisocyanate)
(polymerizing agents)

(2, 2-dichlorovinyldimethylphosphate)

(dieldrin)
(megakaryocyte hypopl

asia)

(pyrethrin)
/ (hexachlorocyclo-
hexane/lindane)
(chlorophenothane, DDT)
(turpentine)
(immune)
(vinyl chloride)

(hypersplenism)

4.6

1.

(plexus)

(cauda equina) 4

(polyradiculopathy)
(polyneuropathy) (myopathy)
4.5

105

4.5

(Nitrousoxide)
(organophosphates)

(myeloneuropathy Babinsky sign

(n-hexane)
myelopathy
and polyneuropathy)

4.6
(polyneuropathies)


4.6 (polyneuropathies)

(acrylamide)

(carbon disulfide)
-
(ethylene oxide)
(thallium)
(methyl bromide)
(polychlorinated biphenyl, PCBs)
(n-hexane)
(methyl n-butyl ketone)

-

(cis-platinum)
-
(pyridoxine)

106

- 5
(trigeminalneuropathy)

(thallium)
(trichloroethylene)

(acrylamide)

(n-hexane) (thallium)
(vacor, PNU)
(benzene)

(carbon monoxide) (dioxin)
(methyl methacrylate)
(pyrethrins)




(myelinopathy)
(axonopathy)

(upper motor neuron, UMN)
(ankle clonus)
(lower motor
neuron, LMN)

4.7 UMN LMN

UMN

(spastic paralysis)


(hypertonia)

LMN

(flaccid paralysis)
/
(atrophy and/or fasciculation)

(hyotonia)

UMN

(deep tendon reflex) (hyperreflexia)

(abdominal
reflex)

107

LMN

(hyporeflexia)

Long tract signs, Babinskis

sign, Clonus

(neuromuscular junction) (myasthenia gravis)

(periodic
paralysis)

chronic relapsing dysimmune polyneuropathy (CRDP)

(anterior horn cell)

(corticospinal) (corticobalbartract)

(Brown-Sequard syndrome)

108

(hanging sensory loss)

(
5) ( 7)
( 9 10) ( 12)
LMN
(hemisphere)
UMN


(normal pressure hydrocephalus)





1.1 UMN (onset)
(cerebrovascular disease) (demyelinating
disease) LMN
(beri-beri) (Guillain-Barre
syndrome) (neuromuscular junction)


1.2

1.3

1.4


1.5

109

4.8

(parkinsonism)

(basal ganglia)


(extrapyramidal
motor pathways)


(motor neuron


disease)


(polyneuropathy)


2.

(syncope)












3.

110

()

- (chronic toxic effect of Lead)

- (chronic toxic effect of Mercury)
- (chronic toxic effect of Manganese)
- (acute toxic effect of fumigants)
- (acute toxic effect of solvents)
- Inhalation fever
- Mill fever
- (metal fume fever)

111

- (humidifier fever)

- (organic dust inhalation fever)

- (polymer fume fever)

- (acute radiation sickness)

- (acute toxic effect of
organophosphate & carbamates)

- Methemoglobinemia (cyanosis)

-
(chemical asphyxiation)

4.

finger to nose

- (simple asphyxiation)
(helium argon)

-
(chemical asphyxiation)

112

- (acute toxic effect of Pentachlorophenol)

- (acute toxic effect of solvents)

- (acute toxic effect of
organophosphate & carbamates)

5.

72

- (acute toxic effect of fumigants)

- (chronic toxic effect of Carbon disulfide)

- (chronic toxic effect of Mercury)

- (chronic toxic effect of Arsenic)

- (acute toxic effect of
organochlorine insecticides)

6.

113

- (chronic toxic effect of Lead)

- (chronic toxic effect of Mercury)

- (chronic toxic effect of Manganese)

- (acute toxic effect of Fumigants)

- (acute toxic effect of
organochlorine insecticides)

- (acute toxic effect of
organophosphate & carbamates)

() ()



7.

40


8. (encephalopathy)






- (chronic toxic effect of carbon disulfide)

- (acute encephalopathy)

-

114

4.9

(diffuse cerebral
hemispheres)

(diffuse cerebral
hemispheres)

9.

10.




- Inhalation fever

- Mill fever

- (metal fume fever)

- (humidifier fever)

- (organic dust inhalation fever)

- (polymer fume fever)

115

4.10
(blue-violet)
(nail cyanosis)

(aniline)

(transverse white lines,
Mees lines)
(diffuse bown)

(longitudinal bands)

(white nail
syndrome/leukonychia)

(yellow ocher)

(bichromates)

(brown
bands)

116

(brownish)

(dinitrochlorobenzene,
DNCB)

(onychomadesis
{completeseparation of one
or more nails from its nail
bed})
(onychalgia)

(white bands)
(broen bands)
(softening nail
plate)
(permanent loss of one
nail) (hypertrophic
nail plate)

(dark gray,
argyria)

(Mees lines)

(thallium)

(cubbing)

117

4.11

bitter almond

118

119

5.1

1.
1.1
1.2 /

/

l
l :

120

1.3
1.4
( )
1.5
(
)
1.6

/
l

Heat stroke

(discomfort)

l Hand-arm vibration syndrome :

2.

2.1


2.2

l ( )

() ()
l ( )
l :

(wrist

drop)

121

/
:
1. -
2. -

3. -

l

l :

2.3
(

122

/

(
aplastic anemia
)

2.4
(

) ( )

2.5
(parathion,

malathion, chlorpyrifos)

(methomyl, carbaryl, l
aldicarb, carbofuran)
(DDT,
l

chlordane, aldrin, dieldrin,

lindane, heptachlor)

123

3.
Bacillus anthraces
Brucella abortus/suis
Yersinia petis
Leptospira interrogans
Rabies virus
Mycobacterium tuberculosis
Hepatitis B / C virus
HIV
H5N1-Influenza virus
SARS-Corona virus

l (anthrax)
l (brucellosis)
l (plaque)
l (leptospirosis)
l (rabies)
l (tuberculosis)
l / (hepatitis B / C)
l
l (avian influenza)
l (SARS)

4.
/

de Quervains

tenosynovitis, Triggerfinger, Bursitis,

Epicondylitis, Carpal tunnel syndrome,

Occupational low back pain

l

l
5.

(occupational stress)

124

5.2 /
/

1.

2.

1.




2.



3.
4.

5.
:

6.

l

:

125

/

l :
1.

(acoustic trauma)



2.
(noise induced
hearing loss)



: l

:

126

l
l
l l



l
l


(air borne pathogen)

(blood borne pathogen)
l
l
l :
l

l
l :






l
l

l
l :

l l

l





l








l
l

l
-
:



- :

127

/


l :





l
:







l

l

-




-

l

128

l
l

/

l
(bagassosis)

-


4-6
-


l
l
-
-
-
l
l

- :

- :


-
1

129

/


2






l
l


-




l
l
l
l

l


l


l



l


l

(silicosis)

l
l
(coal workers
pneumoconiosis)
l

130

l






l







l




l






l













l

/

l :



l
-
-
-
l :


l (silicosis)




l (asbestosis)
l

l

(mesothelioma)





l (silicosis)

l
l

l

l

l
() l
l

l

l



l
l

l







l
l


arc welding
l

131

/

l
l
l
l :




l
l
l
l

l
l
l
:


l
l

l
(pneumoconiosis)
l
l

132

l





l

l

/

l (asbestosis)
l
l


l
l

l
l


l
l
l
l

l
l

l ()
l


l
l
l
l ( batch) l
l ( batch) l

l ()
l


l

l ()
l
l :
l

l (talc)
l

l (asbestosis)
l
l

l
l
l

l
l

133

/

l
l
l
l

l

l
l
l
l -
l -
l lsocyante


l lsocyanate :


(paint stripping)

(finishing)

l
l
l
l
l

134

/

l
l
l
l


l
l (byssinosis)

l
l


l

l

(

)

l
l











l




l l







l
l
l
l

l
l

135

l
l



l
l

l
l
l
l
-
l
l
l
l



l Polycyclic aromatic l
hydrocarbon


l
l
l
l

l
l



l
l



l
l
l
l



l l
(hand arm

vibration syndrome) :

136

/

l

137

(primary prevention)

100%

(secondary prevention)
(tertiary prevention)

1.


3

138

1.1 (sources)



- (elimination)

- (substitution)

- (enclosures)

- (local extract ventilation)

- (redesign of work

process)

1.2 (pathway)

- (shielding)

- (dilution ventilation)

-

-

-

1.3

-

-

139

- (Personal Protective Equipment)

2.








1) (pre-employment or pre-placement
health examination)


2) (periodic health examination)

1

3)

4)


5)

140

1)



2)

3)
(biomarker)

3.

141

142

()

143

, , , Rheumatology for the
non-rheumatologist. : ; 2551.
. [online]. 2004 [ 30 2551]
URL : http://www.vgnew-epd.com/standard/tscotitle.asp
, Fibromyalgia. :
2552.
.
. 2547.
.
.
. 2543.
, .. :
; 2548.
, . : ; 2543.

80 5 2550.
.
, .
80 5 2550.
.
. Understaning the Fibromyalgia Diagnosis criteria.
2552
. Mypfacial Pain Syndeome[]. [ 20 2552]

URL: http://ratanava.mymaindata.com/site_data/mykku_med//
701000019//myofascial%20pain%20syndrome.DOC

144

. Fibromyalgia[] .[ 20 2552]
URL:http://ratanava.mymaindata.com/site_data/mykku_med/701000019//
Fibromyalgia.doc
. :

. 11.
: ;2547.
. (Low back pain)
[ ] . [ 25 . .2551] URL : http://
www.thairheumatology.org/download/guideline-lbp.pdf
.
. :
; 2541
. : / /
.

. 2542.
. Psychiatric Aspects of Fibromyalgia.

2552
, . . : ...;
; 2548.
, .
. : ; 2547.
. .
. [online]. [ 22 2551]. URL : http://
thaigcd.ddc.moph.go.th/
Adams RM.Occupational skin diseases. New York:Grune&Stratton, 1983:1.
Akira M. Uncommon pneumoconiosis: CT and pathological findings. Radiology
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Centers for Disease Control and Prevention. Viral Hepatitis. Centers for Disease
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from: http://www.cdc.gov/hepatitis/index.htm.
Chong S, Lee KS, Chung MF, Han J, Kwon OJ, Kim TS. Pneumoconiosis:
Comparison of imagings and pathologic findings. Radiographics
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2008;63:969-80.
Fisher AA. Occupational dermatatitis,in contact dermatitis.5 ed Philadelphia:
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Kellehr P, Pacheco K, Newman LS. Inorganic dust pneumonitis: the metal-related
parenchymal disorders. Environ Health Perspect 2000;108: 685-96.
Klipple JH, Dieppe PA. eds. Rheumatology 3rd ed, Mosby : Philadelphia 1997.
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Koh D, Jeyaratnam J, Chia KS. Prevention of Occupational Diseases. In: Koh D,
Chia KS, Jeyaratnam J. (eds). Textbook of Occupational Medicine
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Shusterman DJ. Polymer fume fever and other fluorocarbon pyrolysis-related
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2008 [cited 2008 Dec 22]. Available from: http://en.wikipedia.org/wiki

(Glossary)

(Glossary)

supfuric acid
hydrochloric acid
potassium nitrate
oxalic acid
hydrorfluoric acid
glutaraldehyde
nitrous gases
arsine
chlornaphazine
chlornaphthalenes
chlorine
chlorotrifluoroethylene
chlorofluorocarbon
chloroform
chlorophenol
4-chloro-o-toluidine
chloride
carbon disulphide
carbon tetrachloride
carbonmonoxide
carbamates
cadmuim
calcium carbonate
cobalt
chromium

147

148

(Glossary)

sulphur dioxide
sulfonamides
zinc oxide
silica
cis-platinum
digitalis
2,4-dichlorophenol
2,2-dichlorovinyldimethylphosphate
diquat
dinitro-o-cresols
dinitrochlorobenzene, DNCB
dinitriphenols
dimethylformamide
dioxin
dioxane
dieldrin
lead
2,3,7,8-tetrachlorodibenzo-p-dioxin
tetrachloroethane
tetrachloroethylene
2,4,5-trichlorophenol
1,1,1-trichloroethane
trichloroethylene
trinitrotoluene, TNT
polychlorinated biphenyl
copper
tartrates

(Glossary)

turpentine
toluidine
toluene
toluene diisocyanate
thallium
nickle
naphthalene
naphthylamine
naphthalene diisocyanate
nitrates
nitroglycerin
nitrogen oxide
nitrogen dioxide
nitroaniline
butadiene
benzidine
2-benzyl-p-dichlorophenol
beryllium
bariumsulfate
bromide
bichromates
bipyridyls paraquat
mercury
potassium chlorate
potassium dicromate
antimony

149

150

(Glossary)

p-dichlorobenzene
p-phenyldene diamine
pentachlorophenol
polychlorinated biphenyls, PCBs
polyurethane
pyrethrin
fluoride
formaldehyde
phosgene
phophorus
phenol
phenylhydrazine
methane
methyl n-butyl ketone
methyl methacrylate
methylene dianiline
4,4-methylene bis 2-chloroaniline
methylene biphenyl isocyanate
methyl bromide
methylene diphenyl diisocyanate
methylene dianiline
manganese
monobutyl ether
uranium
resin
asbestos
lithium

(Glossary)

vanadium
vacor
vinyl cloride
vinylidene chloride
styrene
zinc
organic nitro-compounds
fumigants
arsenic
p-chloroaniline
halogenated hydrocarbons
hydrocarbons
ethylene glycol
aluminium
cadmium oxide
tin oxide
ferric oxide
organophosphates
o-toluidine
o-benzyl-p-chlorophenol
organochlorine
acrylamide
4-aminobiphenyl
aluminum
aluminium hydroxide
epoxy
ethylene glycol dinitrate

151

152

(Glossary)

ethylene glycol monomethyl
ethylene cholrohydrin
ethylene dichloride
ethylene glycol
ethylene oxide
n-hexane
aniline
ammonia
ammoniapersulfate
ozone
isocyanates
halogenated hydrocarbons
hexachlorocyclohexane
hexachlorobutadiene
hexachlorobenzene
hexafluoropropane
hexamethylene diisocyanate
hydrazine
hydrogen sulfide

153

Website

Website .
http://www.safety-stou.com/

http://www.ohswa.net/n/tabid/53/Default.aspx
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http://www.siamhrm.com/?name=hr&file=category&catsearch=11

http://medinfo2.psu.ac.th/commed/occmed/ohpsu.html
Ramathibodi Poison Center
http://www.ra2.mahidol.ac.th/poisoncenter/

http://occ.ddc.moph.go.th/

http://oshthai.labour.go.th

http://www.chemtrack.org/chem.asp

http://www.thaioccmed.org/indexasso.html
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http://www.shawpat.or.th

http://www.diw.go.th/diw/m52_index.html

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