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Occupational health nursing: workplace hazards, the occupational history and the SG-SST

  • Safe practice

Work can make people sick; the nurse asks about every job, links symptoms to exposures and helps control hazards from the source to protective equipment.

Updated

What it is

Many occupational and environmental diseases look like common problems or vague symptoms, so ATSDR (CDC) says an exposure history should be taken from every patient. It covers current and past jobs (including short, seasonal and part-time work), tasks, exposures, protective practices and the timing of symptoms. In Colombia, Decreto 1072 de 2015 obliges all employers and contractors to run an occupational safety and health management system (SG-SST): a step-by-step process of continuous improvement to anticipate, recognise, evaluate and control risks, with workers taking part. Prevention follows the hierarchy of controls: elimination, substitution, engineering controls, administrative controls and, last, personal protective equipment. The nurse assesses, teaches and supports health surveillance.

What it requires

  • Exposures to ask about: metals, dust, fibres, fumes, chemicals, biological hazards, radiation, noise and vibration.
  • Decreto 1072 (art. 2.2.4.6.24): the employer supplies PPE at no cost to the worker and runs health surveillance with entry, periodic and exit medical evaluations.
  • Workers must look after their health, give true information about it, follow SG-SST rules and report hazards (art. 2.2.4.6.10).
  • PPE only works when used correctly and consistently and should not be the only control when better options exist (NIOSH).

Components

  • The worker: job, tasks, exposures, symptoms and their timing.
  • The workplace: hazards, controls, ventilation and PPE.
  • The system: SG-SST, health surveillance and the occupational risk insurer.
  • Prevention: hierarchy of controls and training.

How it is applied (and why)

  1. Ask what the person does on a normal day, not only their job title — tasks reveal exposures.
  2. List every job, past and present, including farm, informal and seasonal work — old exposures cause late disease.
  3. Ask about dust, fumes, chemicals, pesticides, noise, vibration, lifting and night work — each points to a different risk.
  4. Ask whether symptoms improve away from work and whether coworkers or family have them — timing suggests a work cause.
  5. Ask about ventilation, protective equipment, eating or washing at work — habits change the dose of exposure.
  6. Record exposures and refer for evaluation when a work-related disease is suspected — it opens the route to diagnosis and protection.
  7. Teach safe practices and correct PPE use, after higher controls — PPE is the last barrier, not the first.
  8. Take part in health surveillance (entry, periodic and exit evaluations) and in the SG-SST — early detection prevents disability.

In nursing practice

  • Noise: ask about hearing protection and refer for hearing evaluation when there is exposure or hearing complaints.
  • Pesticides: ask about mixing, spraying and washing practices and household exposure.
  • Low back pain: look at lifting, posture and pace of work and teach body mechanics.
  • Dust in mining, quarrying or construction: ask about cough and breathlessness and years of exposure.

Common mistakes

  • Recording only «worker» or «farmer» without tasks or exposures.
  • Starting with PPE when the hazard could be eliminated or controlled at the source.
  • Forgetting informal, seasonal or household work.
  • Not recording the suspected link with work, so the case is never studied.

Test yourself

Think of the answer, then tap the question to see it.

Why should an exposure history be taken from every patient?

Because many occupational and environmental diseases look like common problems or vague symptoms and are missed without it (ATSDR).

What is the order of the hierarchy of controls?

Elimination, substitution, engineering controls, administrative controls and personal protective equipment.

Which Colombian norm requires employers to run an SG-SST?

Decreto 1072 de 2015 (Decreto Único Reglamentario del Sector Trabajo), chapter 6 of title 4.

Which clue in the history suggests a work-related cause?

Symptoms that improve away from work or on days off, or coworkers with similar symptoms.

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Taking an exposure history (case studies in environmental medicine) (Agency for Toxic Substances and Disease Registry (ATSDR), CDC, 2024); Decreto 1072 de 2015 (Decreto Único Reglamentario del Sector Trabajo), cap. 6: Sistema de Gestión de la Seguridad y Salud en el Trabajo (Función Pública, Gestor Normativo, Colombia, 2015); About hierarchy of controls (NIOSH, Centers for Disease Control and Prevention, 2024).

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Representative model, for educational purposes only.