Surveillance of Work Related and

ROSS, D.J., SALLIE, B.A. MCDONALD, J.C. (1995) SWORD 94 surveillance of work-related and occupational respiratory disease in the UK. Occupational Medicine, 45, 175-178. 

The first element in risk assessment is knowledge of the chemical exposures of a workforce to see if a known sensitizer is present. A chemical becomes accepted as a cause of occupational asthma if there are at least two convincing clinical case reports from independent centres. Specialist clinicians are likely to be aware of the published literature at an early stage and may be a useful source of informal information. There is currently much interest in publishing lists of sensitizers. One is available in a recent textbook (Chan-Yeung and Malo, 1993). The Health and Safety Executive in the UK, the National Institute for Occupational Safety and Health in the USA and other agencies may publish lists with updates. Other sources of information on causes are reporting schemes such as SWORD (Surveillance of Work-related and Occupational Respiratory Disease) in the UK (Ross el al., 1995) and SENSOR (Sentinel Event Notification System for Occupational Risks) in some states in the USA (Matte et al., 1990). 

Respiratory sensitisers may be referred to as asthmagens. In 1989 Surveillance of Work Related Respiratory Disease (SWORD) was started and contains reports by respiratory and occupational physicians. 

Details of the mechanism of action and clinical consequences of overexposure to OP and CM anti-ChEs arc given in other chapters of this book. However, the possible adverse effeets that may result from acute and repeated overexposure are briefly summarized here as a preliminary to the needs and requirements for surveillance of workers potentially exposed to OP.s and CMs. Although the objectives of medical, and indeed any, surveillance programs are to detect the early onset of adverse effect.s and to confirm that health and safety mea.sores are proceeding in a satisfactory, effective, objective, and planned manner, the ultimate goal is prevention of work-related morbidity and mortality (Schnitzer and Shannon, 1999). 

Stout, Nancy, Michael S. Frommer, and James Harrison. 1990. Comparison of Work-Related Fatality Surveillance in the USA and Australia. Jourrud of Occupational Accidents. 13 195-211. 

Specific medical protocols are written and standardized (work) plans for providing medical treatment to employees. They are comparable to the standardized procedures that you may already use in some areas of your business—for example, your system for maintaining accounts or servicing company equipment. You must provide your medical provider a set of protocols for treatment of work-related injuries, for response to emergency situations, for collection of data from medical surveillance programs, and/or for all the other activities listed in your medical program. 

Risk assessments will identify circumstances where health surveillance will be appropriate. Legal requirements for such surveillance extend beyond exposure to substances hazardous to health. Generally, there will be a need if there is an identifiable disease or health condition related to the work, there is a valid technique for its identification, there is a likelihood that the disease or condition may occur as a result of the work, and the surveillance will protect further the health of employees. Examples where these conditions may apply are vibration white finger and forms of work-related upper limb disorders (WRULDs). 

The pharmaceutical industry presents many new challenges to such a person which include the interface with pharmacy and pharmacology, toxicological research, human volunteer studies, clinical trials and post-marketing surveillance to name just a few. Product safety is a factor which impacts on all of those endeavours and the pharmaceutical physician will be expected to work and provide advice within that framework. It will be clear to anyone that evidence of lack of safety in a medical product is not good news for the company concerned and that some level of protective action will often be required which in extreme circumstances may involve product withdrawal. It is, therefore, essential that the pharmaceutical physician should be absolutely clear what constitutes lack of safety in relation to the intended use of the product. 

N10SH. 1999. Work-related lung disease surveillance report 1999. Washington, DC U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies. DHHS (NIOSH) Publication No. 96-134. 

The women of fertile age working with harmful occupational factors should be treated as "vulnerable" groups in relation to disorders of development of a fetus and newborn s health. They demand careful medical clinical and laboratory monitoring and surveillance by an expert in occupational health. It is because these women frequently suffer by early beginning of toxicoses of 2-th half of pregnancy, anemia of pregnant... 

As discussed in ANSI Z-365 (1999), surveillance is defined as the ongoing systematic collection, analysis, and interpretation of health ruid exposure data in the process of describing and monitoring work-related cumulative trauma disorders. Surveillance is used to determine when and where job analysis is needed and where ergonomic interventions may be warranted. 

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