Vocation info helps health investigators

Health investigators at Drexel University want medical centers to start asking patients what kind of work they do.

Jennifer Taylor, a professor of environmental and occupational health, does research to keep firefighters safe. But says she's uncovered an issue that matters for a lot of workers: we're not collecting information that could connect health issues with what's happening in workplaces.

"It's really important that we advocate for policies that get us the critical minimum information we need, just like getting their gender or their race-ethnicity," Taylor said.

Hospitals collect race and gender information now, and it's used to uncover health disparities. Likewise, hospitals report information on gun injuries. And in the past, statistics on motor-vehicles deaths have helped in campaigns for seat belt and helmet laws.

Taylor said imagine a baker who has a constant cough. If doctors don't ask about his job, they might never diagnose baker's asthma, she said.

"If we had asked, we could have given you a modification, a protective mask or changed your job duties--or something--to help you stay employed, but not be exposed to what was making you ill," she said.

Collecting job information can help individual patients, Taylor said. Those individual patient reports, aggregately, pile up to drive public health debates for an entire population, she argues. And those debates, she says, sometimes translate into new industry-wide regulations.

Taylor's team took its proposal to the national committee that sets the universal codes used for medical billing. George Arges, chairman of the National Uniform Billing Committee, isn't convinced, yet.

Arges said imagine that same baker with the hacking cough used to be a firefighter.

"What do I code? Is this something that's part of his current occupation as a baker or is it something that should be identified as a previous occupation as a firefighter?" Arges said.

He said skeptics want to make sure there's software that can make sense of all the jobs people report.

"The government has actually already figured it out," Taylor said.

She said the National Institute for Occupational Safety and Health has developed "tech solutions" to accurately gather occupation and workplace information. And, she said, every ten years, the U.S. Census collects handwritten information on the jobs people do.

Arges said he's heard about software that can help hospitals classify patients, but no one has demonstrated those systems to his committee. He said he'd welcome a state-level demonstration project to show that the technology works.

Taylor makes her case in a new article published in the Journal of Occupational and Environmental Medicine. She wants to add two questions to the list collected by hospitals.

"Two tiny little data elements, not a big ask: 'What do you do for work, what is your job title? And, in what kind of industry do you do that?'" Taylor said.

Asked about the cost of adding those "two tiny little data elements" to millions of hospital intake forms, Taylor said she's not sure, but guesses that the cost of not adding them is big.

The medical and indirect expenses related to workplace injuries and illnesses cost America more than the medical and indirect expenses linked to cancer, Taylor said.

"I don't think anybody knows that," she said. "It's $250 billion."

Taylor said a database of patient occupations would be helpful beyond firefighting, factory work and other traditionally high-risk industries. As cities like Philadelphia move away from a manufacturing base, the country needs information on knowledge-based jobs, too, she said.

It might be important to know if journalists, for example, suffer higher rates of burnout or Carpel tunnel syndrome.