Agency for Toxic Substances and Disease Registry 
Case Studies in Environmental Medicine (CSEM) 

Taking an Exposure History
How to Use This Course

Introduction

The goal of Case Studies in Environmental Medicine (CSEM) is to increase the primary care provider’s knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. This CSEM focuses on taking an exposure history.

Available Versions

Two versions of the Taking an Exposure History CSEM are available.

• the HTML version http://www.atsdr.cdc.gov/csem/exphistory/ provides content through the Internet and offers interactive exercises and prescriptive feedback to the user;
• the downloadable PDF version provides content in an electronic, printable format, especially for those who may lack adequate Internet service.

Instructions

To make the most effective use of this course, we recommend that you

• take the initial check to assess your current knowledge about taking an exposure history
• read the title, learning objectives, text, and key points in each section
• complete the progress check exercises at the end of each section and check your answers
• complete and submit your assessment and posttest responses online if you wish to obtain continuing education credit.

Continuing education certificates can be printed immediately upon completion.

Instructional Format

• This course is designed to help you learn efficiently. Topics are clearly labeled so that you can skip sections or quickly scan sections you are already familiar with. This labeling will also allow you to use this training material as a handy reference. To help you identify and absorb important content quickly, each section is structured as follows

Title

Serves as a "focus question" that you should be able to answer after completing the section

Learning Objectives

Describes specific content addressed in each section and focuses your attention on important points

Text

Provides the information you need to answer the focus question(s) and achieve the learning objectives

Key Points

Highlights important issues and helps you review

Progress Check exercises

Enables you to test yourself to determine whether you have mastered the learning objectives

Progress Check answers

Provides feedback to ensure you understand the content and can locate information in the text

Learning Objectives

Upon completion of the Taking an Exposure History CSEM, you should be able to

Overview

• explain the importance of taking an exposure history
• explain why primary care clinicians should be knowledgeable about the exposure history process
• explain why the exposure history taking is important in daily practice

Exposure Pathways

• explain how organ systems may be affected by toxic exposures
• identify the possible sources of toxicants from indoor air pollution
• identify the possible sources of toxicants in the home and environment

Questioning the Patient

• describe the components of an exposure history
• explain how temporal relationships between patient’s symptoms and patient’s home or work environment are identified
• identify specific questions asked in the work history
• evaluate a possible temporal relationship between patient’s symptoms and patient’s workplace
• identify specific questions asked in the environmental history
• evaluate a possible temporal relationship between patient’s symptoms and patient’s home and surrounding environment
• explain why patients need to provide detailed information about their past and current exposures from their jobs and homes

Summary

• recognize resources available that help identify toxicants
• explain to the patients why they need to provide all the detailed information about their past and current exposures from their jobs and homes