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The purpose of this study was to identify the prevalence of occupational exposures, their potential contribution to the development of chronic diseases among medical inpatients, and their recognition by house officers. Occupational histories were obtained from 101 medical inpatients and their charts were reviewed. Sixty-six percent of patients had diseases for which an occupational etiology merited consideration. A relevant occupational exposure was discovered in 68% of patients with a disease potentially attributable to occupation. Specific disease/exposure pairs were associated with each other (P = .001). Senior house staff recognized fewer relevant exposures (17%) than did interns (55%) (P < .001). Relevant occupational exposures are common among medical inpatients, but frequently go unrecognized because of an inadequate fund of knowledge in occupational medicine among physicians.

Recent community studies have suggested that low level lead exposure is significantly associated with blood pressure in the general population. This finding is inconsistent with the results of recent occupational studies of lead exposed workers, although the occupational studies contained serious methodological weaknesses. The present study examined the relation between occupational lead exposure and diastolic and systolic blood pressure in randomly selected samples of 270 exposed and 158 non-exposed workers. Four exposure indicators were examined: employment at a lead battery plant nu a control plant, current blood lead value, current zinc protoporphyrin value, and time weighted average blood lead value. After controlling for other known risk factors such as age, education, income, cigarette usage, alcohol consumption, and exercise, the associations between exposure and blood pressure were small and non-significant. In the absence of a biologically feasible hypothesis regarding the mechanism by which low level lead exposure would influence blood pressure the present findings challenge the validity of the general population association.