Haematological disorders

Few haematological disorders are caused or exacerbated by work. However, they may affect an employee’s capacity to work. Mild haematological derangements (e.g. iron deficiency anaemia, anticoagulant treatment) are common, but have only minor implications for employment. Conversely, genetic and malignant haematological diseases, although comparatively uncommon, are complex and affect young people of working age. Malignant disease has a profound impact on work capability during the treatment and early recovery phases. However, advances in clinical management achieve a much greater potential for return to work during treatment, and a growing population of survivors in whom it is important to address employment issues. The evidence base contains little research about fitness for work related to haematological disease, functional rehabilitation, or prevalence rates for specific disorders in the working population. The likelihood of an occupational physician encountering haematological disease in fitness for work assessments is therefore based on occurrence in the general population and this chapter relies primarily on traditional textbook teaching, and recent reviews of advances in clinical management. It contains brief summaries of the more common haematological disorders that an occupational physician might encounter when advising about fitness for work. The major determinants of functional capacity are similar for many haematological conditions. In order to avoid repetition the common treatments, complications and symptoms are covered under ‘Generic issues’.