High-Risk Occupations

Although most nickel sensitization results from nonoccupational exposures, nickel dermatitis was historically a problem in workplaces where there was a high risk of continuous contact with soluble nickel, eg, in electroplating (qv) shops. Improved personal and industrial hygiene has largely eliminated this problem. However, there are a few occupations involving wet nickel work, particularly where detergents faciUtate the penetration of skin by nickel, where hand eczema may occur (126). 

CalabreseE. 1978. Pollutants and high risk groups The biological basis of increased human susceptibility to environmental and occupational pollutants. New York, NY John Wiley and Sons. 

Adults at high risk for hepatitis B because of occupation or lifestyle should receive the hepatitis B vaccine series. The typical series has the second and third doses given 1 month and 6 months after the first dose. Accelerated schedules may also be used. Frequently, individuals do not follow through with the complete three-dose series and questions arise about restarting the series. Hepatitis B vaccine produces an amnesic response therefore the series may be continued at any time in order to complete the three doses. 

Major Building severely damaged. High risk of severe injury to occupants caused by building damage. Downtime in excess of 90 days. 

As discussed in Chapter 4, some risk-based decision making can benefit by the development of tolerance criteria for the various types of risk to which building occupants may be exposed. When identified risks are higher than what can be deemed tolerable, they should be eliminated or reduced to control the company s risk exposure. The process of risk identification and evaluation, comparison to tolerance criteria, and elimination or reduction of intolerably high risk is known as risk management. Figure 6.1 illustrates this process. Application of these tolerance criteria helps protect building occupants and ensure that resources are appropriately applied. 

Many dietary and environmental factors have been implicated as possible etiologic factors in the development of pancreatic cancer, but no definite causal relationships have been established. The strongest evidence points to cigarette smoking as a risk factor associated with pancreatic cancer (20-24). Occupational exposure to certain chemicals has also been linked to pancreatic carcinoma (25). Others in the high-risk group include stone miners, cement workers, gardeners, textile workers, and leather tanners (17,26). 

Wigle DT. 1977. Bladder cancer Possible new high-risk occupation [letter]. Lancet 2 83-84. 

Regarding the extrapyramidal side effects commonly found after treatment with the "classical neuroleptics, PET studies of schizophrenia patients have shown that such drugs occupy 70-80% of D2 receptors in the basal ganglia at therapeutic doses. It has been calculated that a D2 receptor occupancy in the basal ganglia of approximately 80% carries a high risk that the patient will develop extrapyramidal side effects. Furthermore, Canadian studies have shown that the occurrence of extrapyramidal side effects was a major predictor for the subsequent development of tardive dyskinesia. 

Flammability test procedure for mattresses for use in high-risk occupancies... 

For the legislator, the question arises as to whether the (possible) infectivity of a dentist (physician) constitutes an exceptionally high risk and to what extent hygiene-related stipulations and other legal measures can provide a remedy. The legislator, however, reserves the right to prohibit the practice of certain occupational activities in whole or in part . In some cases, this channel has already been pursued by the responsible authorities (even somewhat inappropriately). 

Silicosis is the oldest known occupational lung disease. Ancient Greeks were familiar with lung disease in quarry workers (Hippocrates) and the fact that respirators could prevent the disease (Pliny). Agricola (1566) described disease in stone cutters as later did Ramazini (1713). By 1917, the US Public Health Service identified sand blasters and foundry workers to be at high risk of silicosis. As the twentieth century progressed, silicosis was the reference to which newer diseases were compared. 

---