Occ Med Guidance: Returning to Work After a Respiratory Infection
In recent weeks I've noticed that many staff members were recovering from upper respiratory infections (usually a cold). I've received questions about the criteria for safe return to work during convalescence from such illnesses.
This can be a difficult decision. It's not necessary or feasible to require yourself to be completely asymptomatic before returning to work. For instance, sometimes cough can persist for many weeks. Such "post bronchitic coughs" aren't contagious the way early-stage coughs are.
Here are my suggestions:
- Don't return to work until you feel well enough to do so.
- Don't return if, off medication, you have muscle aches because those strongly imply that you are still contagious.
- Most importantly, don't return if, off medication, you have a fever. Define fever as an elevation above the temperature range that's typical for you when you aren't ill. For instance, often your temperature is measured during routine visits to your physician. If you don't have a feel for your non-ill baseline temperature, then assume it is 98.6 F and consider fever to be 99 or higher. There are medical operational definitions of fever. For instance to some physicians, fever is 1.5 degrees above baseline. I don't recommend bothering with these definitions. Most of them are intended for use in triggering medical interventions. The most protective definition for return to work is the one I mentioned above.
- There are many exceptions. For instance prolonged cough can be from TB (tuberculosis), not post-bronchitic convalescence. Fever can be from cancer. My suggestions assume the context of an uncomplicated cold-like illness.
- If you aren't sure whether you can safely return to work, you can consult your personal physician or call Occ. Med. at ext. 7539 or 5585.
Occ Med Director Provides Information on 3D Mammography
The purpose of this note is to call attention to the existence of 3D mammography. This technology has become more available since its introduction in 2010 and evidence is accumulating that it might provide important scientific advantages, along with possible logistical and expense-related disadvantages.
For instance, 3D appears to detect up to 41 percent more early cancers. This can result in detection of cancer more than a year earlier than standard technology would. In addition, 3D decreases the need to call women back for additional imaging of suspicious areas.
Regarding logistical and financial disadvantages, the Sentara mobile mammography van that visits JLab annually doesn't have a 3D unit. However, Sentara's nearby brick and mortar center does. Sentara is considering adding mobile 3D capability but hasn't decided yet. You can read about Sentara's mammography program at: http://sentaracaresmammogram.com/hamptonroads2/?_vsrefdom=p.4389. In addition, Riverside and Bon Secours also provide mammography services.
I recommend that women learn about 3D mammography. WebMD has provided a useful overview at: http://www.webmd.com/breast-cancer/news/20140624/3d-mammograms-may-improve-breast-cancer-screening?page=3.
In addition, the most recent American Cancer Society guidelines are located at: http://www.cancer.org/healthy/informationforhealthcareprofessionals/acsguidelines/breastcancerscreeningguidelines/index. Links lead to an explanation of why the Society doesn't yet provide guidelines about 3D.
Thank you for considering this update. If you are uncertain about whether to utilize 3D technology, please consult your personal physician.
Foreign Travel Medicine Program Requires Early Notice of Travel
For JLab staff members who engage in foreign travel for the lab, be aware that Occupational Medicine provides Travel Medicine support services. For maximum benefit, staffers who anticipate upcoming foreign travel should submit their travel plans to the Foreign Travel Management System as soon as possible and also visit the CDC Travel Medicine site as far in advance of travel as possible.
After the employee has reviewed the CDC recommendations, she or he should contact JoAnne Newman, x5585, for questions and requested service, such as vaccine administration. For the full memo regarding foreign travel medicine support service procedures and associated challenges, visit the Occupational Medicine website.