摘要:

Current and former workers who have been occupationally exposed to hazardous substances have unique medical and social needs. Few programs recognize and accommodate the needs of these workers. Consequently, screening and medical surveillance assume a pivotal role in a system that inadequately deals with the needs of workers identified and notified of occupational disease risks. In some cases, screening programs, ineffective in altering survival patterns, are established because they represent surrogates for other kinds of support programs that do not exist. Where screening techniques are effective and available, there still are problems in getting them funded and established in acceptable programs. This paper details these problems and argues for increased research to enhance the efficacy of screening, not only in preventing disease, but also in improving the quality of life for workers at risk.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Medical screening and biomedical monitoring violate individual rights. Such conflicts of right with right are acted upon synergistically by uncertainty which, in some important respects, increases rather than decreases as a result of research. Issues of rightness and wrongness, ethical issues, arise because the human beings who are subjects of medical screening and biological monitoring often have little or no option whether to be subjected to them. We identify issues of rightness and wrongness of biomedical surveillance for various purposes of occupational health and safety. We distinguish between social validity and scientific validity. We observe that principles are well established for scientific validity, but not for social validity. We support guidelines as a way forward.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This paper presents a method for developing occupational medical examinations using the preplacement examination (PPE) and the periodic monitoring examination (PME). The steps for developing an appropriate PPE include goal definition, analysis of job requirements and potential exposures, an occupational and medical history, and a targeted physical examination derived from the preceding steps. The PPE should result in the proper placement of the worker. It also serves as a baseline for comparison to future testing or health-related developments. The PME checks the effectiveness of more primary preventive measures such as plant engineering controls and personal protection. The contents and frequency of the PME depend on the pathophysiology and toxicology of the hazardous exposures, the interval exposure and medical history, and legal requirements. Individual and group results should be assessed periodically for trends suggesting work-related problems that would need further evaluation.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Traditional quantitative methods for evaluating neuropathy may be problematic or insufficiently sensitive as screening tools; standard electrophysiological techniques (nerve conduction velocities and electromyography) are often no more sensitive or reproducible, and in some cases are less sensitive, than the clinical neurological examination. Several promising methods for the evaluation of subclinical neurotoxic effects, including somatosensory and visual evoked potentials, quantitative sensory testing of temperature and vibration, and specialized nerve conduction testing, will be discussed. The crucial issues of sensitivity, standardized test procedures, reproducibility, and practical application in the field setting are currently being examined for these and other techniques. It should be recognized, however, that a brief, directed clinical examination may currently serve as the best screening battery for certain neurotoxins. The most appropriate screening tests can be devised when the neurotoxin is identified and its effects known.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Exposure to workplace toxins, particularly organic solvents, lead, and pesticides, has been shown to cause both transient and persistent derangements of CNS function. Neurobehavioral testing is described as a means of evaluating the health effects of exposure to toxic chemicals. The use of neurobehavioral testing is most appropriate where an exposure has been characterized and the diseases of interest specified. Most investigators use batteries of tests to evaluate psychomotor function, memory, verbal ability, mood, and visual/spatial abilities. Because of the shortcoming of the interviewer-administered test batteries, existing neurobehavioral tests have been adapted to a computer-administered format. This tool offers promise for future efforts to monitor CNS function in exposed workers.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Due to the ever-increasing problems associated with carpal tunnel syndrome in the workplace where exposure to neurotoxic substances may also occur, measure of nerve function addressing both of these neuropathies is needed. Limitations in the standard neurological examination and nerve conduction studies have resulted in efforts to develop portable instruments for quantitative sensory testing. Fingertip vibration perception is altered in carpal tunnel syndrome and toxic neuropathies. Vibration perception is described for the median-innervated II digit and the ulnar-innervated V digit using an Optacon tactile stimulator. Discussion focuses on the interaction between toxic and entrapment neuropathies as reflected by vibration thresholds.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Low-back pain continues to be a major industrial health problem in terms of compensation costs and disability. Preemployment lumbar spine radiographic screening was first used on a large scale during the early post-World War II period. Since then, numerous publications have argued for or against its use. Nevertheless, studies have been limited to one company or industry, controls have been lacking, and the research design has often been poor. This paper summarizes the available infomation and argues for the need to design and implement a study to determine the value of preemployment radiographs in predicting future low-back pain and injuries.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

One of the Food and Drug Administration's educational programs to optimize the use of medical radiation is the investigation of the efficacy of selected x-ray film examinations. The goal of this program is to provide clinical information needed to aid physicians in their judgment. The routine chest-radiograph screening examination has been studied, and recommendations for five applications of chest-radiograph screening have been published. These recommendations, plus results of FDA research on the efficacy of low-back radiography, are discussed.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Three separate screening studies have tested the sensitivity and specificity of quantitative fluorescence image analysis for detecting bladder cancer. Nuclear intensity (NI) measurements of fluorescent dye-stained epithelial cells from voided urine and bladder washings were compared with routine Papanicolaou (Pap) cytology results, and findings were verified against pathological biopsy diagnoses. The NI cytology method detected the pathologically confirmed tumors earlier and with greater specificity than did conventional cytology. In the study of 140 clinically symptomatic patients in Oklahoma, the NI method detected 91.1% (31 of 34) of the pathologically confirmed grades 1 and 2 tumors and 100% of 18 grades 3 and 4 tumors. Pap cytology detected only 47% (16 of 34) of low-grade and 78% (14 of 18) of high-grade tumors. Comparable results were obtained in a study of symptomatic patients in Mississippi and the method has been employed in the screening of a high-risk occupationally exposed cohort in Georgia.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID