The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.
To obtain baseline information with respect to occupational medicine practice in Canada, a questionnaire survey of members of the Occupational and Environmental Medical Association of Canada was carried out by mail in 1993. One hundred eighty-six responses were received (56% of the membership). The average age of the respondents was 49.5, 12% were female, and 55% worked full-time in occupational medicine. Practice types included corporate settings (58%), clinics (23%), government agencies (14%), worker's compensation boards (7%) and academic settings (5%). Sixty percent had some formal training in occupational medicine, and 46% had occupational medicine certification by either the Royal College of Physicians and Surgeons of Canada, the Canadian Board of Occupational Medicine, or the American Board of Preventive Medicine. Younger physicians were more likely to be female and have gone directly into occupational medicine. Women were more likely to be working full-time in occupational medicine but worked fewer hours per week. Those physicians with specialty qualifications were older and more likely to be working full-time in occupational medicine and be active in professional activities. The Association intends to continue surveying its members on a triennial basis, identifying trends in the practice profiles and continuing education needs.
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