Medical surveillance Health Hazard Evaluation Program investigation The mission of a medical surveillance program is to keep workers healthy and ensure that employers are meeting
OSHA standards in health and safety. Medical surveillance has an emphasis on prevention: it is designed to detect potential workplace hazards before irreversible health effects can occur. Clinicians with expertise in occupational health, industrial exposures, and respiratory protection screen workers with physical examinations, blood testing, spirometry (a measurement lung function), and audiometry. Screenings are performed at set intervals, often annually. The clinicians providing medical surveillance services include board-certified
occupational and
environmental medicine physicians,
mid-level practitioners, nurses, and NIOSH-certified spirometry technicians. • An initial medical examination and collection of medical and occupational histories • Periodic medical examinations at regularly scheduled intervals, including specific medical screening tests when warranted • More frequent and detailed medical examinations as indicated on the basis of findings from these examinations • Post-incident examinations and medical screening following uncontrolled or non-routine increases in exposures such as spills • Worker training to recognize symptoms of exposure to a given hazard • A written report of medical findings • Employer actions in response to identification of potential hazards When the purpose of a medical surveillance program is to detect early signs of work-related illness and disease, it is considered a type of
medical screening, to detect preclinical changes in organ function or changes before a person would normally seek medical care and when intervention is beneficial The establishment of a medical screening program should follow established criteria, and specific disease endpoints must be able to be determined by the test selected. Hazard surveillance is an essential component of any occupational health surveillance effort and is used for defining the elements of the risk management program. Critical elements of a risk management program include recognizing potential exposures and taking appropriate actions to minimize them (for example, implementing engineering controls, employing good work practices, and using personal protective equipment). Hazard surveillance should include the identification of work tasks and processes that involve the production and use of hazardous materials, and should be viewed as one of the most critical components of any risk management program. Hazard surveillance includes elements of hazard and
exposure assessment. The hazard assessment involves reviewing the best available information concerning toxicity of materials. Such an assessment may come from databases, texts, and published literature or available regulations or guidelines. Human studies, such as
epidemiologic investigations and
case series or reports, and animal studies may also provide valuable information. The exposure assessment involves evaluating relevant exposure routes (inhalation, ingestion, dermal, and/or injection), amount, duration, and frequency (i.e., dose), as well as whether
exposure controls are in place and how protective they are. When data are not available, this will be a qualitative process. ==Occupational Health Indicators (OHIs)==