General Principles of Medical Surveillance

Abstract

Objective-As potential occupational exposure to nanomaterials becomes more prevalent, it is important that the principles of medical surveillance be considered for workers in the nanotechnology industry.Methods-The principles of medical surveillance are reviewed to further the discussion of occupational health surveillance for workers exposed to nanomaterials.Results-Because of the rapid evolution of nanotechnology, information may not be available to make a well-informed determination of all factors needed to evaluate risk of health effects from occupational exposure to nanomaterials. Conclusion-Everyworkplace dealing with engineered nanomaterials should conduct hazard and exposure assessments as part of an overall surveillance needs assessment for nanotechnology workers. In workplaces where risk is felt to be present, or at least cannot be ruled out, initiation of medical surveillance is prudent to protect workers' health.The principles of medical surveillance are an essential component of occupational health practice. 1-3 As the production of (and potential occupational exposure to) nanomaterials becomes more prevalent, it is important that these principles be considered for workers in the nanotechnology industry. DEFINITIONS AND BACKGROUNDOccupational health surveillance is the ongoing systematic collection, analysis, and dissemination of exposure and health data on groups of workers for the purpose of preventing illness and injury. Occupational health surveillance can help to define the magnitude and scope of occupational health issues among groups of workers, with the ultimate goal of prevention; occupational surveillance data are used to guide efforts to improve worker safety and health and monitor trends over time. The general term occupational health surveillance includes hazard and medical surveillance. Although the focus here concerns medical surveillance, integration of hazard and medical surveillance is

Enterprise-Based Participatory Action Research in the Development of a Basic Occupational Health Service Model in Thailand

“…Implementation in conjunction with the medical surveillance program includes: (1) a walk-through survey; (2) identifying hazards; (3) industrial hygiene data; (4) significant exposure and health risk assessment; and (5) the design of medical surveillance comprising history, physical examination, and biomarkers of exposure and effect; and (6) medical examination [ 35 , 36 ]. Following the identification of the issues, action plans were developed.…”

“…The development of the medical surveillance model is summarized in Table 6 . Compared with elements of a medical surveillance program, it comprises: 1. a walk-through survey; 2. known hazards; 3. a measurement area or personal sampling; 4. an action level or health risk assessment; 5. the design of medical surveillance programs; 6. medical examinations at regular intervals; 7. the provision of information to employees; 8. the interpretation of the ongoing data analysis of the test; 9. medical removal; 10. a written report; 11. the employee’s work environment re-evaluated as necessary; 12. medical record keeping; 13. audits; and 14. employer actions [ 35 , 36 ]. The new activities were developed according to the components of a medical monitoring program listed in the brackets in Table 13 .…”

Barriers and Facilitators in the Creation of a Surveillance System for Solar Radiation-Induced Skin Cancers

“…Most of these strategies could potentially be used for designing an OSH surveillance system for outdoor workers or more specifically for KC cases or UVR exposure. Table 1 (exposure registry, [32][33][34] disease registry, 32,[35][36][37][38] disease screening [39][40][41][42] ) and Table 2 (sentinel event surveillance, 32,43,44 disease surveillance via data linkage 22,33,45,46 ) present the five surveillance strategies with a short definition, strengths, limitations, a current example, characteristics, and whether the strategy could be applicable to KC or solar UVR. Each strategy has strengths and limitations and cannot perfectly accomplish all surveillance goals, which is a key finding.…”

Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials

“…Occupational health surveillance consist of environmental (exposure) surveillance and medical surveillance, a component of which is medical screening [15]. Medical surveillance involves the continuous systematic collection, analysis and interpretation of specific health events (clinical monitoring) and/or changes in/of biological functioning (biological monitoring).…”

“…Medical screening is a complementary activity to surveillance aiming to detect early signs of work-related illness by administering tests to apparently healthy persons. Screening activities typically have a clinical focus when compared to surveillance, but medical screening data that is collected utilizing a standardized approached, aggregated and analysed longitudinally lends itself to be evaluated as a part of a surveillance program [15]. The purpose of a surveillance programme is: i) to serve as an early warning system; ii) to monitor the effectiveness of health interventions over time and; iii) to conduct research and inform public health policy.…”