A case study: Is it work related? A 49 year old porter has been sick for 8 months with low back ache. He says he was injured back at work. His back ache has not improved with physiotherapy and analgesia. He has difficulty walking up and down the stairs and is breathless on exertion. His occupation history is seen below: •     left schools at 16 years •     had numerous labouring jobs in the construction industry for 20 years •     worked on a tunneling project for 1year and a half •     worked as a lorry driver for a beverage company for 8 years •     worked as a hospital domestic assistant for 2 years •     and has been employed as a hospital porter for 11 years What occupational hazard might account for his breathlessness? How would you assess whether his symptoms are work related or not? What are the possible causes of his back ache? What advice would you give him? Is he likely to return to work? What work might he be able to do? Briefly explain the differences between industry related (i.e. occupational and environmental) health problems in developed countries compared to those in developing countries.