Health: Stabbed, bitten and deafened, it's all in a day's work: Being made redundant can damage your health. But some jobs hurt, too, reports Carol Cooper

IF you are given your P45, perhaps you should be handed a health warning along with it, since unemployment is so bad for general well-being. Although mental health is most often affected, job loss poses risks to physical health as well. It increases the chances of a man dying in the following 10 years by about 30 per cent, and raises the risk of illness in his wife and among his children too.

Poverty, stress and perhaps the adoption of a less healthy life style may help to explain this. The effects are said to be greater when unemployment is sudden or unexpected. But this cannot be the whole story, because simply the threat of losing a job can similarly increase the risk of ill health.

On the bright side, there are a few crumbs of comfort for those who have been made redundant, or fear they will be: having a job can be bad for your health as well.

Occupational diseases have been around for centuries. Traditional afflictions include the benign 'miner's elbow' (a form of chronic bursitis) and the more serious 'chimney-sweep's cancer'. This cancer of the scrotum was common back in the days when the sweep went up the chimney along with his brush, saturating his clothing and skin with various carcinogenic coal-tar derivatives.

The end of the last century was the heyday of 'boilermaker's deafness'. This was induced by persistent noise levels above 100dB - even greater, experts say, than you would find in a pighouse at feeding time.

Miners, sweeps and boilermakers have all but disappeared, but occupational diseases have not gone away. As tools and materials have changed, so the pattern of diseases has altered. In 1893, washerwomen's hands were afflicted by repetitive strain injury (RSI). More recently this disorder has moved upmarket through biscuit packers and car workers, to clerks and beyond.

Although RSI gets most of the publicity, the hand is at risk in many other ways. 'Policeman's heel' - inflammation of the tissues deep within the heel - may be on the way out, but a common form of assault is a bite on the hand, generally inflicted by someone resisting arrest. Human bites are not trivial. They are potential sites of entry for diseases such as hepatitis, as well as for more mundane infections. A vicious bite can also cause much direct physical damage, and the occasional assailant has been known to lose a tooth in the wound.

A doctor's life and limb are also at risk. Tradition has it that orthopaedic surgeons are in greatest danger, because of their instruments and the strength and enthusiasm with which they wield them. During the course of operations, surgeons have been known to slice the tips of their fingers off, impale their assistants' hands and stab colleagues in various parts of their anatomy.

Less macho specialities have their own hazards. About 7 per cent of healthcare workers in the United States, and probably a similar proportion in the United Kingdom, suffer from an allergy to the latex from which gloves are made. Symptoms can vary from a skin eruption shortly after the gloves are put on to a severe generalised reaction that could cause a doctor to collapse during an internal examination.

But latex has been around for years, so why all the trouble now? One theory is that it may be due to the accelerated processing of latex to meet increased demands for condoms and rubber gloves; allergens may have been removed in previous methods. In some cases problems can be circumvented by using vinyl or synthetic latex gloves (and condoms could also be fashioned from sheep intestines. Plus ca change . . .).

For publicans, alcoholism is the usual hazard, as anyone can guess from the traditional Hogarthian physiognomy across the counter. New trends, though, bring new problems. One young bartender tried to uncap a bottle of tonic with his teeth. The bottle broke at the neck and cut his lip, and the pressure of gas in the tonic injured the tissues deep within his neck.

Noise continues to be troublesome in many jobs. Although it can have the useful effect of increasing arousal and alertness when the job in hand is boring or repetitive, it worsens the performance of mental arithmetic and complex tasks, and makes accidents more likely.

By triggering the fight-or-flight mechanisms in the body, noise also increases levels of aggression and anxiety. And there is good cause for anxiety - noise is probably the major cause of deafness in the Western world. The people who are making all the noise are usually in greatest danger, and members of the noisiest rock bands are said to have profound hearing loss.

Finally, it can be a help to remember that financial success has its price. Some people become allergic to money. According to a study in Germany, about 10 per cent of the population are allergic to the nickel that is found in coins, with dermatitis developing on the sufferer's hands when they are handling a lot of cash.

The author is a general practitioner in London.