All in a day's work-related illness

By BBC Doctor Colin Thomas

"Don't you miss being a GP?" is a question I am quite often asked, normally followed by: "Well what made you take up occupational therapy then"?

Now, I've got nothing against occupational therapists, but their line of work bears only a very passing resemblance to the study of occupational medicine which essentially is looking after the health of people at work.

I can see how people get confused between the two titles, and I've racked my brains on many occasions trying to think of a 'sexier' title, but have failed miserably.

"Industrial health" was a title used years ago, but this just sounds like a high strength disinfectant floor cleaner.

In the outside world many small enterprises would have precious little concept of what health at work is all about, but I managed to put my occupational disease knowledge to good use recently in a small business, and save some money to boot.

Actually "boots" is what it was all about. I had taken two pairs of my shoes in to be soled and heeled and had decided to go really early to the shop to pick them up.

Coldfinger

I was the first customer, and when I arrived the first thing the proprietor asked me to do was shut the door.

"I've just come in on my bike and I've got very cold hands and it takes them a while to warm up" he said.

He was fiddling with some small shoe tacks in a box, and was having difficulty manipulating them. He even dropped one on the floor.

He tutted and took my ticket to look for my shoes, and as he did so I noticed that his fingers looked quite blue.

"Your fingers" I said, "are they always prone to the cold"?

Bad vibrations

"Oh yes, " he replied, "they even get cold in the warmer weather sometimes when I'm riding my bike."

My mind started to whirr into action as I conjured up a mental picture of him holding numbers of shoes to the nailing machine, the buffer and the sander.

Could it be that he was suffering from vibration white finger ?

It was a possibility, so I asked him some more questions and gave him some advice. This certainly took him aback, but he seemed quite interested in what I had to say as he could see it made sense.

He had for example no idea that excessive exposure to vibration over a period of time could cause this sudden circulation cut off in the fingers, and I'm quite sure wouldn't have had the first idea what an occupational physician like me was.

"How much will that be?" I said.

"That's £12 per pair, but make it £15 for the two and we'll call it quits" he replied.

I was sorely tempted to go to the bank next door to see how much the bank manager would part with if I spotted his RSI.