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Table 1 The four questions giving rise to suspicion of the occupational nature of a disease.

From: The Primary Care Practitioner and the diagnosis of occupational diseases

HISTORY TAKING IN OCCUPATIONAL MEDICINE

Criteria for causal relationship in epidemiology

Queries to be addressed to the patient

Temporal relationship

1. What is the time lag between the initial exposure and the start of the symptoms ?

Dose-effect relationship

2. Do the symptoms improve if the patient is not exposed any longer (e.g. if he/she changes work duties or is on holiday?

3. Do the symptoms worsen if the patient carries out specific duties or works in areas characterised by high levels of exposure?

Strength of the association

4. Are colleagues affected by the same symptoms related to the same exposure?