An exposure history form has three components: Exposure Survey, Work History, and Environmental History. The main aspects of an exposure history (summarized in Table 3) will be elicited through the exposure history form.
Although a positive response to any question on the form indicates the need for further inquiry, a negative response to all questions does not necessarily rule out a toxic exposure etiology or significant previous exposure. All patients should complete exposure history forms, although the form does not need extensive evaluation in every clinical situation. As in all data-gathering activities, sound clinical judgment must be exercised.
Although a positive response to any question on the form indicates the need for further inquiry, a negative response to all questions does not necessarily rule out a toxic exposure etiology or significant previous exposure.