Why I became an occupational physician
It was in the 1970s that I first had experience of dealing with work-related disease. I was climbing the National Health Service career ladder towards becoming a consultant physician and spent 2 years in Glasgow Western Infirmary's respiratory unit. Unfortunately, there was little which could be done therapeutically for the majority of the work-related respiratory disease I saw. But one morning at the asthma clinic, a patient attended with features of ‘late onset’ asthma. She told me about her work in a food factory where dried packet soups were produced and how she used a compressed air jet to clean the soup dust from the machinery thus releasing clouds of dust into her lungs. Investigations followed, using samples of the soup ingredients as a basis for immunological skin testing and inhalation challenge tests. These confirmed an occupational cause and incriminated mushroom dust as the key allergen. Visits to the factory led to the discovery of others with similar symptoms and liaison with the company's doctor facilitated environmental improvements [1]. Was this patient—‘the case who changed my career’? Well, she certainly stimulated me to consider how health gains could be achieved through environmental changes rather than conventional therapeutics.Some other work-related health projects then came my way, including a study of firemen's health and smoke inhalation. This led to liaison with Eric Blackadder, the head of the Employment Medical Advisory Service (EMAS) in Scotland. His enthusiastic approach was quite inspirational and EMAS's range of activities at that time appeared impressive. He had just returned from a Scotland-wide study of distillery workers which established the prevalence of malt workers lung, and this project had allegedly involved sampling a wee dram at each establishment. It became clear that there were doctors who actually worked full-time in this field and, sensing my interest, Eric asked me to consider becoming an occupational physician.
I did eventually apply for an EMAS post but the Civil Service application form had a complete page entitled ‘previous relevant experience’. As I had no direct experience, I filled the space with work activities during medical school vacations. These included construction work in tunnels, catering, driving trucks, labouring in sub-zero refrigeration plants, functioning as a docker and, most stressful of all, instructing people how to drive. During the interview chaired by Suzette Gauvain, with Ken Duncan and Peter Taylor providing a formidable team, the questions focussed mainly on my experiences in these environments and I demonstrated at least some knowledge of the world of work.
And so I was successful in being recruited to the ideal job with 50% of my time devoted to practical EMAS service activity and 50% to teaching and research in the Department of Community and Occupational Medicine in the University of Dundee, with Professors Alex Mair and Bill Taylor. I never looked back and I consider myself most fortunate to have had the support of these distinguished mentors, along with many others, during these early years.
Email: is.symington{at}ntlworld.com
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- Symington IS, Kerr JW, McLean DA. Type 1 allergy in mushroom soup processors. Clin Allergy (1981) 11:43–47.[CrossRef][Web of Science][Medline]
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