Realizing that this may indeed be some type of environmental exposure, you and your medical student obtain a more detailed environmental history from the patient, keeping in mind the CH2OP mnenomic (Community, Home, Hobbies, Occupation and Personal Habits) Following is an an example of questions that should be in your environmental history. The link to the results of your patient's environmental history follows the sample history.

ENVIRONMENTAL HISTORY

After establishing the chief complaint and history of present illness, there are screening questions that should be asked to elucidate the role of environmental toxins in the presenting condition. Poisonings may mimic conditions of other etiology. You need to know the environmental health history to diagnose the case.

Screening Questions for Environmental Exposures (should be asked in most cases):

  • Do you think the child’s health problems are related to the home, daycare, school, or other location?
  • Has there been any exposure to pesticides, solvents or other chemicals, dusts, fumes, radiation, or loud noise?
  • What kind of work do the parents or other household members engage in?

Detailed Environmental History (should be asked when environmental etiology is suspected):

  1. Do you live next to or near an industrial plant, commercial business, dump site,
    or nonresidential property?
  2. Which of the following do you have in your home? Please circle all that apply.
    Air conditioner Air Purifier Central Heating (gas or oil)
    Gas Stove Electric Stove Fireplace
    Wood Stove Humidifier  
  3. Have you recently acquired new furniture or carpet, refinished furniture or
    remodeled your home?
  4. Have you weatherized your home recently?
  5. Are pesticides or herbicides (bug or week killers, flea and tick sprays, collars,
    powders, or shampoos) used in your home or garden or on pets?
  6. Do you (or any household member) have a hobby or a craft?
  7. Do you work on your car?
  8. Have you ever changed your residence because of a health problem?
  9. Does your drinking water come from a private will, city water supply,
    or grocery store?
  10. Approximately what year was your home built? _____________

If you answered yes to any of the questions, please explain.

Click here for the environmental history for this patient.

<< BACK NEXT >>