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Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Impetigo


Text Only Home | Graphic-Rich Site | Overview | Risk and Causation | Diagnosis | Treatment | Prognosis | Differential Diagnosis | Specialists | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Failure to Recover | Medical Codes | References

Medical Codes

ICD-9-CM:
684 - Impetigo; Impetiginization of Other Dermatoses; Impetigo (Contagiosa) [Any Site] [Any Organism]: Bullous; Circinate; Neonatorum; Simplex; Pemphigus Neonatorum

Related Terms

  • Pyoderma

Overview

Image Description:
Impetigo - Closed lips and a portion of the chin are shown. A crusty growth of small blisters is depicted at one corner of the lower lip and the skin below it.
Click to see Image

Impetigo is a superficial infection of the skin by Staphylococcus aureus and/or Streptococcus pyogenes bacteria. There are two forms of impetigo: bullous, and superficial or common. Bullous impetigo is caused by Staphylococcus aureus and is characterized by thin-walled blisters that rupture and develop a thin, varnish-like crust. Superficial or common impetigo is caused by Streptococcus pyogenes alone or in combination with Staphylococcus aureus and is characterized by thick, adherent, yellow crusts with a red border. The most likely regions to be affected are the face, scalp, and extremities. Impetigo at a deeper level of skin, usually in an unexposed area (the legs), is called ecthyma.

Incidence and Prevalence: In pediatric clinics, impetigo accounts for 10% of all presenting skin problems in the US (Lewis). Impetigo is more common in warm, humid climates. Internationally, impetigo occurs most frequently at lower altitudes, in tropical climates.

Source: Medical Disability Advisor



Causation and Known Risk Factors

Risk factors include poor hygiene and overcrowded environments. Impetigo affects primarily children and adolescents.

Source: Medical Disability Advisor



Diagnosis

History: The individual may complain of an itchy, rapidly spreading rash or fluid-filled blisters. There may be a history of a minor breach in skin integrity, such as a cut, insect bite, or herpes outbreak.

Physical exam: Individuals with common (superficial) impetigo have the typical small, multiple, red-rimmed collections of pus (pustules) with adherent dirty-yellow-colored crust. Large, fluid-filled blisters that leave a thin crust are present in individuals suffering from bullous impetigo. Some individuals may present with both types of lesions. Nearby lymph nodes may be swollen. The affected region may have evidence of pre-existing scabies, eczema, herpes, or lice infestation (pediculosis).

Tests: A microscopic examination (Gram stain) of a sample of the pus will confirm the infection. Bacterial cultures and antibiotic sensitivity testing may be performed.

Source: Medical Disability Advisor



Treatment

Topical or systemic antibiotics are used to treat this infection. The crusts may be gently removed after soaking the affected area in a warm antiseptic solution. Frequent application of wet dressings to affected areas is recommended.

Source: Medical Disability Advisor



Prognosis

Impetigo is easily treated with antibiotics and has an excellent prognosis. Left untreated, impetigo should spontaneously resolve in time.

Source: Medical Disability Advisor



Differential Diagnosis

Source: Medical Disability Advisor



Specialists

  • Dermatologist
  • Family Physician
  • Infectious Disease Internist

Source: Medical Disability Advisor



Comorbid Conditions

  • Immune system disorders

Source: Medical Disability Advisor



Complications

Deeper infection of the skin is possible, forming a boil. Impetigo involving Staphylococcus aureus may progress to staphylococcal scalded skin syndrome, characterized by large sheets of peeling skin. However, this syndrome is rarely seen in individuals over the age of 12 years. In rare cases, Streptococcus infection can result in acute kidney disease (glomerulonephritis), scarlet fever, hives (urticaria), and erythema multiforme.

Source: Medical Disability Advisor



Factors Influencing Duration

The severity of the infection and the appropriateness of the antibiotic may influence the length of disability.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Because impetigo is highly contagious, the individual should avoid direct contact with others until the infection has cleared. Maintaining moderate ambient temperature and humidity in the workplace can help to reduce future infection. Healthcare workers and childcare personnel may need to be off work until lesions clear.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have signs of impetigo, such as blisters or lesions with thick yellow crusts and red borders?
  • Are lesions located on the face, scalp, and/or extremities?
  • Has there been a history of insect bites, herpes, or skin lacerations?
  • Are physical findings consistent with the diagnosis of impetigo?
  • Did a Gram stain or culture identify the presence of Staphylococcus aureus or Streptococcus pyogenes?
  • Have other conditions with similar symptoms been ruled out in the differential diagnosis?

Regarding treatment:

  • Has the causative bacteria been subject to sensitivity testing to confirm that the appropriate antibiotic treatment was undertaken?
  • If symptoms persisted following antibiotic treatment, were lesions recultured to determine if bacteria are resistant to current antibiotic therapy?
  • Has antibiotic been changed?

Regarding prognosis:

  • Has individual had this infection before?
  • Does individual have an underlying condition that may affect ability to recover?
  • Did individual complete the entire course of antibiotic?

Source: Medical Disability Advisor



References

Cited

Lewis, Lisa S., and Allan D. Friedman. "Impetigo." eMedicine. Eds. Glenn Fennelly, et al. 24 Aug. 2004. Medscape. 8 Oct. 2004 <http://emedicine.com/ped/topic1172.htm>.

Source: Medical Disability Advisor