ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The National Cancer Institute (NCI) develops and supports a broad range of research relevant to screening for preneoplastic events and biological effects of carcinogen exposure. In cancer screening and detection, NCI supports studies on development of new methods for detecting cancer and/or preneoplastic states, systematic testing of new screening methods, and wider application of established methods. Recently, NCI developed clinical trials in chemoprevention and dietary intervention. These studies focus on populations identified by markers of exposure or markers of increased risk, and have as their end point reduction in cancer incidence.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Data from 4,500 workplaces surveyed by the National Institute for Occupational Safety and Health (NIOSH) in the National Occupational Hazard Survey (1972 to 1974) and National Occupational Exposure Survey (1981 to 1983) show an increase in both preplacement and periodic medical screening in US industries during the past decade. The distribution of screening is primarily related to plant size, but also varies considerably by industry type; further, plants with industrial hygiene and safety programs and/or unions are more likely to provide screening examinations than those without, irrespective of plant size. As for workers potentially exposed to selected chemical hazards, the first survey provides no consistent evidence that such workers were more likely to receive expo-sure-specific tests than other workers. The significance of these findings is discussed in the context of the proposed framework for medical screening practices developed by NIOSH researchers.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This paper will consider medical surveillance in the context of the Occupational Safety and Health Act of 1970. The Occupational Safety and Health Administration (OSHA) has issued (after rule making) health standards covering approximately 24 toxic substances, and all these standards have included medical surveillance programs. OSHA is not only empowered but compelled by law to require medical surveillance programs for exposed employees. At the same time, a number of major legal/policy issues relating to medical surveillance have been raised at the standards rule-making stage and litigated in court. Among the more significant of these are access to medical records, selection of physician, and medical removals. Many of these issues were involved in OSHA's Lead Standard, issued in 1978 and affirmed in relevant part by the Court of Appeals for the District of Columbia in

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This paper discusses the economic and legal incentives for using biological monitoring to detect occupational disease. The limitations of workers' compensation statutes and the various theories of liability for occupational disease are described. After a description of the general principles governing liability, the following issues are discussed: the liability that may result when employers fail to biologically monitor their employees; the company physician's personal liability; liability of manufacturers of hazardous substances; and the employer's duty to report known diseases to affected employees.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Presently, there are few legal restrictions on the use of medical screening of workers. The Occupational Safety and Health Act (OSH Act) requires that certain medical tests be performed when workers will be exposed to specific toxic substances. The OSH Act does not, however, prohibit the use of any medical screening measure nor does it indicate what actions an employer may or may not take as a result of such information. (A notable exception is the medical removal provision of the Lead Standard.) This paper discusses that protection afforded under Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act, and the Rehabilitation Act of 1973. This paper will demonstrate that the law has, in general, failed to take into account the discriminatory aspects of medical screening.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Preventive and anticipatory programs for identifying workers at higher-than-normal risk for occupational injury and/or disease can now draw on an expanding net of sophisticated diagnostic tests. New genetic screening tests may use reagents developed through recombinant DNA technologies, including cDNA probes for genetic variants such as HLA B27 associated with late-appearing disability.Assessments of the readiness of these technologies to be incorporated into standard occupational policy turn on their predictive value, applications, and the locus of control of the data which they generate. The question of responsibility for health protection and obligations accruing to those who uncover genetically fixed risk status has major ethical implications. Issues of potential stigmatization, discrimination, and protection of equal employment opportunity must be resolved before these tests are put into practice. The possible use of genetic testing to assure minimal risk and its equitable distribution among workers is highlighted as a possible benefit of this new applied technology.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This paper addresses the following questions concerning medical surveillance and the worker's relationship to management: Do workers have a moral obligation to participate in workplace screening and monitoring when undertaken to enhance the interests of occupational health? What conditions would be necessary to establish the existence of such a moral obligation? If such an obligation were to be established, ought it be satisfied solely on the basis of voluntary collaboration? Is compulsory participation in monitoring and screening ever morally justified? Should the principle of informed voluntary consent that obtains in medical research apply to workplace investigations that involve potentially invasive procedures and risks to privacy?

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Disability determination in the US is traditionally based on the classical medical diease-illness paradigm: if one defines the quantity of disease (pathoanatomical abnormality), one can predict the magnitude of illness (symptoms), including how the illness will operate in the workplace. This inference underlies the Handbook of Social Security Disability Insurance (SSDI) and the early attempts at “schedules” in workers' compensation. The reliability and validity of this inference, however, leave much to be desired. The alternatives currently used include the “expert opinion,” even when based on direct examination, which is heavily used in both programs. The opinion of the worker's personal physician is relied upon only before the administrative law judge in the SSDI program. These administrative alternatives color the doctor-patient relationship and the worker's perceptions of his illness.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The greatest legal impact of medical screening and biological monitoring may be in proceedings to compensate workers for occupational disease. In workers' compensation, failure to demonstrate a disease's work-relatedness has often barred compensation. Screening and monitoring data can add a new causal link by demonstrating longitudinally a worker's reaction to a toxic exposure. Employers may also use the data to rebut claims. In tort suits, the data can help establish causation and aid the admissibility of expert testimony. Of most significance, it may create a higher legal standard of care for employers based on increased knowledge of their workers' health status, which may open up new grounds for suits. These legal implications of greater liability may make employers reluctant to collect medical test data. On the other hand, testing programs may aid them in legal proceedings by demonstrating good faith efforts to reduce disease risks.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID