Exposure health surveillance

Re-assessment to be carried out at as on front cover monthly intervals. Or when no longer valid due to significant change or the results of engineering tests, exposure, health surveillance, or complaints. ... 

Reviews on the occurrence, biochemical basis, and treatment of lead toxicity in children (11) and workers (3,12,13) have been pubhshed. Approximately 17% of all preschool children in the United States have blood lead levels >10 //g/dL. In inner city, low income minority children the prevalence of blood lead levels >10 //g/dL is 68%. It has been estimated that over two million American workers are at risk of exposure to lead as a result of their work. PubHc health surveillance data document that each year thousands of American workers occupationally exposed to lead develop signs and symptoms indicative of... 

Provision and use of appropriate health surveillance, e.g. for signs of dermatitis, asthma, effects of specific solvent exposures. Full use of any spray booth, enclosure, exhaust ventilation or dilution systems, and automatic handling equipment. (The efficiency of all local exhaust ventilation and other control systems should be maintained, and checked by testing.) Where appropriate, atmospheric monitoring of airborne pollution levels. 

Major hazard aspects of the transport of dangerous substances 1991 Recommendations for training users of non-agricultural pesticides Health surveillance under COSHH. Guidance for employers Anaesthetic agents. Controlling exposure under COSHH Risk assessments of notified new substances... 

Provision of adequate information, instruction and training control against exposures by measures other than the use of personal protective equipment provision of adequate washing facilities prohibition of eating, drinking and smoking m contaminated areas and health surveillance are covered. 

Health surveillance is appropriate unless exposure is insignificant (Control of Carcinogenic Substances ACOP, 15-18)... 

Human health biomonitoring using biomarkers and chemical analyses are used in the following applications (1) Health surveillance of persons who are known to have high occupational or environmental exposures to potentially toxic chemicals. This may include those who work with chemicals, radioactive materials, or biohazards as part of their occupation. Examples include factory workers, chemical industry employees, farmers, health care professionals, nuclear plant employees, and veterans of the Gulf War I. This may also consist of those who are involuntarily exposed to such hazards in their everyday surroundings. Some examples are people living near land fills, factories, hazardous waste sites, or environmental catastrophes such as the Chernobyl... 

Schaller KH, Triebig G, Schiele R, et al. 1991. Biological monitoring and health surveillance of workers exposed to mercury. In Dillon HK, Ho MJ, eds. Biological monitoring of exposure to chemicals Metals. New York, NY John Wiley and Sons, 3-9. 

Hurlbut KM, Bernstein JN, Burgess JL, et al Bell s palsy and frontal lobe functional deficit from ethylene oxide exposure (abstract). Vet Hum Toxicol 34 357, 1992 Kelafant GA, Berg RA, Schleenhaker R Toxic encephalopathy due to 1,1,1-trichloro-ethane exposure. Am J Ind Med 25 439-446,1994 Klees JE, Lash A, Bowler RM, et al Neuropsychologic impairment in a cohort of hospital workers chronically exposed to ethylene oxide. Clin Toxicol 28 21-28,1990 Lauwerys R, Herbrand J, Buchet JP, et al Health surveillance of workers exposed to tetrachloroethylene in dry-cleaning shops. Int Arch Occup Environ Health 52 69-77, 1983... 

Health surveillance of workers may be necessary, if there is doubt about exposure being successfully controlled. Surveillance can range from a simple regist of incidents to periodic medical examinations. 

To assess the exposure of sprayers employed in motor vehicle repair shops, Williams et al. also explored biomonitoring methods to measure urinary HDA by GC-MS. Samples were collected among sprayers wearing personal protective equipment and spraying in booths or with local exhaust ventilation, from bystanders, and from unexposed subjects. HDA was detected in four sprayers and one bystander out of 22 workers, while it was not detected in samples from unexposed persons. They concluded that exposure to isocyanates still occurred despite the use of personal protective equipment and the use of a booth or extracted space, and that health surveillance is likely to be required to provide feedback on the adequacy of controls, even if such precautions are used, and to identify cases of early asthma. 

---