Disease disabling

Johnson, R.J. Wolinsky, F.D. The structure of health status among older adults Disease, disability, functional limitation, and perceived health. J. Health Soc. Behav. 1993, 34, 105-121. 

The types of outcomes that result from medical care interventions can be described in a number of ways. One classic fist, called the five D s, although quite negatively worded, captures a wide range of outcomes used in assessing the quality of medical care. The five D s are death, disease, disability, discomfort, and dissatisfaction. 

In this connection, it cannot be overemphasized that while a particular pattern of behavior may be the cause or the consequence of a disease, the behavior, perse, cannot, as a matter of definition, be a disease. Boxing or drinking alcohol may cause diseases but are not diseases. Disability—the inability to earn a living or care for oneself—may be, or may not be, a consequence of disease, but is not a disease. 

What makes a person like Hinckley disabled His ability to shoot others, a premeditated crime that we interpret as a disability due to a disease. Disability produced by deviant ability is as different from disability due to physical limitation as mental illness is different from bodily illness. The bizarre act of a so-called mental patient, whether murder or self-mutilation, is a complex performance, an ability most people lack. In contrast, the disability of a physically sick person, such as blindness or paralysis, is the absence of an innate sensory or motor ability, not the lack of a social skill or the rejection of responsibility. Attributing adult dependency to disabling disease is as fallacious and misguided as is attributing crime to mental illness. 

Applying the SHE concept to the field of occupational and environmental health defines the Sentinel Health Event (Occupational) (SHEA)) as an unnecessary disease, disability, or untimely death which is occupation or chemical exposure related and whose occurrence may ... 

Their paper contains a valuable compilation of occupationally related unnecessary disease, disability, and untimely death. 

What you have read above has dealt with mat r of the workplace sources of disease, disability and ill health. These sources as we noted earlier are called stressors . Each stressor affects particular target cells, organs, tissnes or systems in the body. For information on noise, vibration and ionizing radiation as stressors, see Chapter 10. 

Hospitals, physicians, and other clinicians deal in matters of disease, disability, and death. Many of the patients are frail some are only a step away from the grave. At the next unfortunate turn of events, some will suffer even greater disability others will not survive. 

Inhalation of crystalline or fused vitreous silica dust, usually overlong periods, causes a disabling, progressive pulmonary disease known as silicosis (84). Amorphous siUcas have not been linked to siUcosis (85), but can cause respiratory irritation. The history and poHtics of siUcosis have been reviewed (86). Standards have been set or recommended for occupational exposures (87,88) and review articles on the health effects of siUca are available (83,89). 

The industries which produce and handle various stone products emit considerable amounts of particulate matter at every stage of the operation. These particulates may include fine mineral dusts of a size to cause damage to the lungs. The threshold values for such dusts have been set quite low to prevent disabling diseases for the worker. 

List the diseases prescnbed for the payment of disablement benefit, if related to specific occupations. Conditions due to chemical agents, e.g. poisoning by any of a range of chemicals and certain carcinomas, and miscellaneous conditions, e.g. pneumoconiosis, asthma, diffuse mesothelioma, non-mfective dermatitis are included. 

Rheumatoid Arthritis. Figure 1 The development of disability overtime in a group of RA patients studied prior to the early 1990s. FDI = functional disease index where 1 = moderate disability, 2 = more marked disability, 3 = severe disability and 4 = very severe disability (from Wolfe, Cathey (1991) J Rheumatol 18 1298). 

Penicillamine, MTX, and hydroxychloroquine are used in the treatment of rheumatoid arthritis. The administration of MTX is reserved for severe disabling disease that is not responsive to other treatment. 

The above analysis is somewhat oversimplified and is considered an Incomplete assessment of the existing environmental problems caused by pesticides. Again, it must be emphasized that there is no completely satisfactory way to summarize all of the environmental and social costs in terms of dollars. For example, it is impossible, if not unethical to place a monetary value on human lives either lost, diseased, or disabled because of pesticide use. It is equally difficult to place a monetary value on total wildlife losses. Good health, and Indeed life itself have no price tag. 

Depression is a common, serious, sometimes fatal illness that is chronic and recurrent in nature, impairs family life, reduces social adjustment, and is a burden on the community (Klerman and Weissman, 1992). This disease chronicity magnifies hoth its societal impact and its economic burden. It has been estimated that more than 17% of the disability associated with mental disorders is the result of depressive disorders (Rosenbaum and Hylan, 1999), and that the global burden of depression, measured in terms of disability-adjusted life years, will rank second only to ischaemic heart disease by the year 2020 (Murray and Lopez, 1996). 

MS, a chronic demyelinating disease of the CNS, is the most common cause of non-traumatic disability among young adults (Frohman et al. 2006). At the cellular level, MS is mediated by myelin-specific CD4h- T cells that destroy oligodendrocytes... 

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