CONDITION |
CRITERIA FOR REPORTING (summarized, for details see Criteria Guide) |
| Agricultural Injuries |
Any injury related to farming, forestry,
or fishing which results in death or requires care by a hospital, physician, physician
extender, or chiropractor. Includes
injuries to children. |
| Asbestosis |
Hx of exposure to airborne asbestos dust
and chest X-Ray consistent with asbestosisand/or lung pathology consistent
with asbestos exposure. |
| Byssinosis |
Hx of exposure to cotton dust and Hx of
progressive pulmonary disease. |
| Carpal Tunnel Syndrome |
Sxs and objective findings consistent with CTS
and evidence of work-relatedness. |
| Heavy Metal Poisoning |
|
|
-Arsenic |
Hx of significant occupational exposure to Arsenic and urine
arsenic levels >50 ug/l. |
|
-Cadmium |
Hx of significant occupational exposure to cadmium and blood
cadmium levels >1 ug/dl, or urine cadmium levels >5ug/dl.
|
|
-Lead |
Hx of significant occupational exposure
to lead and blood lead level >25 ug/dl
or urine lead level >80 ug/dl. |
|
-Mercury |
Hx of
significant occupational exposure to mercury and blood mercury
levels greater than 0.5 ug/dl, and urine mercury levels
>20 ug/dl. (24 hr. urine is the diagnostic test of choice.)
/td>
|
| Hypersensitivity Pneumonitis |
Hx of significant occupational exposure to an airborne
antigen known to be associated with the disease and sxs consistent
with Hypersensitivity Pneumonitis.
|
| Mesothelioma |
Tumor pathology consistent with
mesothelioma. |
| Occupational Asthma |
Documentation that the patient has
asthma and that the asthma is associated with some substance or
process in the workplace. |
| Outbreaks |
Illness involving two or more persons
which appears to have resulted from either acute or chronic exposures to chemical,
biological, or physical agents in the same occupational
setting. |
| Pesticide Poisoning |
Hx of employment in the manufacture,
mixing, handling or application of pesticides,
and signs and sxs characteristic of exposure. Laboratory confirmation as indicated.
|
| Silicosis |
Hx of significant exposure to airborne
silica dust and a chest X-Ray consistent with silicosis (without
other clinical explanation) or lung tissue pathology consistent with
silica
exposure. |
| Solvent Toxicity |
Hx of occupational exposure to a
specific agent, and signs and sxs of toxicity; If appropriate, laboratory confirmation of damage
(characteristic of toxic agent).
|
| Toxic Gas Poisoning |
|
|
- Ammonia |
Hx of
occupational exposure and sxs consistent with exposure to gas. |
| - Chlorine |
|
| - Hydrogen Sulfide |
|
| Carbon Monoxide |
Hx of exposure and CoHB >5% at time
of exposure in non-smokers (>10% in smokers). |
|
Submit
Occupational Disease Report forms to:
State of Maine, Occupational Disease Surveillance Registry,
11 State
House Station,
Key Plaza 8th floor.,
Augusta, ME 04333-0011
To order additional forms or for questions call:
(207) 287-5378 or Fax (207) 287-3981 |
