Article Abstract:
Occupational medical screening is intended to detect adverse health conditions that result from hazards and diseases existing in or derived from the workplace. Controls of hazards are frequently determined and applied on the basis of clinical medical judgments and observations of individuals. The most effective control of occupational disease is by primary prevention, which means diminishing or preventing exposure. Secondary prevention, or treatment of the exposed, is less effective in reducing disease. Screening programs are intended to supplement control efforts, not replace them. The importance of screening is that it contributes to the early detection of disease in the individual, and by extension, to those who share his/her exposures and risks. The group obtains the greatest benefits when recommendations are collated and the means of interrupting the exposure-disease chain can be ascertained. Screening for bladder cancer should follow the same set of principles, but effective screening tests for occupationally-related bladder cancer among high-risk groups do not exist. Diagnostic tests are intended to provide direction for medical treatment of a person who is ill. Screening is directed at the person who is asymptomatic and does not feel sick. These tests must meet a set of criteria that will identify the area, activity, and persons at risk, encourage participation and client acceptability, establish means to determine positivity and borderline status, and suggest a management procedure for the borderline and positive cases. The Occupational Safety and Health Administration (OSHA) has issued a notice of proposed rulemaking for a generic approach to the development of standards for testing and surveillance. The National Institute of Occupational Safety and Health (NIOSH) supports this generic approach and is developing recommendations for threshold exposure guidelines and levels, testing and screening criteria, and other related issues. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
It has become common to communicate test results to participants in medical field investigations. This trend was initiated by the dramatic example of this form of communication that occurred in response to the crisis at Love Canal, NY, when residents were informed they may have suffered chromosomal aberrations due to exposure to toxic materials dumped near their homes. The need to communicate field test results is based on the principle of informed consent (or "right to know"). Investigators are confronted with issues of what to tell study participants, how to tell them and when. Based on 15 years of experience at the National Institute for Occupational Safety and Health, investigators have developed the following recommendations for informing participants in medical field investigations: (1) provide a readily understandable consent form; (2) explain test results to participants; (3) use straightforward language; (4) explain when and how findings are uncertain; (5) indicate any and all need for medical follow-up; (6) quickly provide the results of the investigation to participants in the study; (7) provide complete results; (8) evaluate the impact of the communication of the results to the participants in a manner that does not shock, alarm or confuse them; and (9) train investigators to properly communicate results.
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Article Abstract:
Asthma may be briefly defined as a condition of the lungs in which there is widespread narrowing of the airways, due in varying degrees to spasmodic contraction of smooth muscle, edema (swelling) of the mucosa, and mucus inside the bronchi and bronchioles. These conditions can be due to a clinical condition (intrinsic asthma), or they can be allergic or physical responses to foreign stimuli, such as inhaled particles, smokes, pollens, dusts, or ingested foods (extrinsic asthma). The diagnosis of occupational asthma is difficult because of the complexity and variety of stimulants that can trigger this disease. Four cases are detailed, including the demographics of the cases, the symptomatic responses, the work-related stimulants involved and the responses to methacholine challenges. Methacholine challenge is a widely accepted procedure used as a screening test for asthma. Variable responses following the methacholine challenge (MC) were obtained, temporarily associated with workplace exposure to the antigens. Consquently, care should be taken to carefully evaluate patient's symptoms with exposures, and the patient responses to serial methacholine challenges. (Consumer Summary produced by Reliance Medical Information, Inc.)
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