This chapter deals mainly with common acute and chronic neurological problems, particularly as they affect employees and job applicants. The complications of occupational exposure to neurotoxins and putative neurotoxins will also be covered in so far as they relate to the fitness of an exposed employee to continue working. In addition to a few well-known and common conditions, many uncommon but distinct neurological disorders may present at work or affect work capacity. Fitness for work in these disorders will be determined by the person’s functional abilities, any comorbid illness, the efficacy or side effects of the treatment, and psychological and social factors, rather than by the precise diagnosis. This will also need to be put into the context of the job in question, as the basic requirements for a manual labouring job may be completely different from something more intellectually demanding. Indeed, even an apparently precise diagnostic label such as multiple sclerosis (MS) can encompass a complete spectrum of disability, from someone who is entirely asymptomatic to another who is totally incapacitated. Similarly, the job title ‘production operative’ may be applied to someone who is sedentary or who undertakes heavy manual handling. Furthermore, reports by general practitioners, neurologists, or neurosurgeons may describe the symptoms, signs, and investigations in detail, but without analysing functional abilities. These colleagues may also fail to appreciate the workplace hazards, the responsibilities of the employer, or what scope exists for adaptations to the job or workplace.
PND3 THE NATURE AND PREVALENCE OF COMORBID ILLNESS AMONG INDIVIDUALS WITH MULTIPLE SCLEROSIS
