A few years ago I was in the Massachusetts coastal town of Gloucester, and on the seafront there stands a famous monument to fishermen who have died in the Atlantic waters over the years. Fishing is one of the world's most dangerous occupations - 454 British fishermen were lost in the 20yrs to 1995, according to the Health and Safety Executive. Figures from the US Dept of Labour have the most hazardous job there as woodcutting (they seem to have moved on from 'lumberjacks'), with 117 fatalities per 100,000 workers in the year 2002. The combination of large machinery, falling trees and remoteness clearly become an unfortunate set of circumstances. But if you look at the ICD10 coding book of every bad thing that can happen to you ever, there are no specific disorders attributable to these careers, so which job is truly more dangerous?
Being a Housemaid is the classic example of a seemingly dull job that can have painful consequences. Housemaid's Knee (M70.4) is now commonly called by it's anatomical name as the Victorian era of put-upon women scrubbing slate floors has long gone, although 'Prepatellar bursitis' isn't quite as romantic. Shipyard Eye (H79.2) likewise paints a picture of a bygone era (unlike 'Epidemic keratoconjunctivitis'), as does Haymaker's Lung (J67.0), Farmer's Skin (L57.8), and Brass-founder's Ague (T56.8), which is also known as Foundryman's Fever. Inhalation of metallic oxide particles stick to the lungs and cause severe malaria-like symptoms - something the careers guidance counselor won't have mentioned (and I bet they don't have a disease.
If you're collecting body parts to go with your Farmer's Skin and Shipyard Eye, then be on the look out for Tin Miner's Lung (J63.5) and Coal Miner's Elbow (M70.2) - and try not to get them confused, especially if you're calling in sick from your miner's hut as you fancy a day off. Shoemaker's Chest (M95.4), Baseball Finger (S63.1) also sound painful, as does something many people are risking in later life - Beer Drinker's Heart Disease (I42.6) (I don't know if this is any different to the normal heart disease). Baker's Cyst (M71.2) could be for the overly-excited kneaders out there, as could Student's Elbow (M70.2).
There really can't be too many inpatient admissions to Scottish hospitals from people suffering from Pearl-worker's Disease (M86.8), File-cutter's Disease (T56.0), or Cork-handler's Disease (J67.3). And the absolute best of the lot - Milkman's Disease (M83.8) - notable symptoms include an irritating jaunty whistle - which now has been reclassified 'Osteomalacia', the highly common softening of bones due to a deficiency of Vitamin D. Lungs take quite a pounding in these various careers, with Slate-dresser's Lung (J62.8), Fishmeal-workers Lung (J67.8), Arc Welder's Lung (J63.4), Cheese-washer's Lung (J67.8), and surely the most specific job/disease combo in the medical world - Maple Bark-stripper's Lung (J67.6).
Having said that, Kew Garden Fever (A79.1) can't affect too many people (unless it means those aghast at paying £12.25 to get in), and Pituitary snuff-taker's Disease (J67.8) is one from the history books - possibly joining with Pickwickian Syndrome (E66.2) in a Dicken's style illness, with a side-helping of Dabney's Grip (B33.0). Parrot Fever (A70) would be something for bird enthusiast's to avoid, as would the old favourite Bird-fancier's Lung (J67.2). Little-Leaguer's Elbow (M77.0) I can only imagine is restricted entirely to the United States, and for obvious reasons Norwegian Itch (B86) would concern Scandinavians especially (although it's actually another name for Scabies).
So what's the most dangerous job? It has to be the professional pub-quiz attendees who know every capital city, can tell you which countries border others, and the various long rivers or highest mountains. They might know all the answers, but they also run the risk of contracting Geographic Tongue (K14.1)
Previous DUaB ICD10 posts...
How to come to grief
A one-way trip to the vet
