OCCUPATIONAL HEALTH SCREENING
Occupational health screening
Occupational health screening is the methodological
administration of test methods or a series of test methods to individuals with
the aim providing early detection of any organ dysfunction or disease which can
then be treated or its effects alleviated before it worsens (Wagner, 1996:3).
When screening is applied in occupational health with aim of early disease
detection usually as part of medical or health surveillance; it is called
occupational health screening (Vella and Gauci, 1997:26), this is the searching of diseases or
physiologic conditions which may have not been detected in the past which arise
due to the workers’ exposure to environmental or work related factors (Vella
and Gauci, 1997:27).
Occupational health screening is critical because it
lies within the second stage of prevention; it provides information on possible
occurrence of disease which can increase morbidity and mortality (Karvonen, and
Mikheev, 1986:98, Vella and Gauci, 1997:26).
Occupational health screening can be beneficial to both the individual worker
and the group of workers, for instance the early detection of silicosis in a
foundry worker can help other foundry workers when controls are implemented
based on the risk information provided by the screening tests of one foundry
worker. Screening can also assist in epidemiological studies when the data it
provides is used in studies and can provide information which can be used in
planning interventions (Vella and Gauci, 1997:26).
Types of occupational health screening
There are various types of occupational health
screening and their use is dependent on many factors such as ethics,
availability of resources, legal requirements and the seriousness of the
condition or disease; these methods can be used together or in isolation. Types
of occupational health screening are:
Questionnaires: These are a set of well formulated
questions which normally seek get exposure information from the exposed
individual (Vella and
Gauci, 1997:29)
Self-reporting of symptoms can also be used for the
purpose of getting information and interviewing can form part of this as the
worker or individual is asked specific questions to better understand if their
symptoms are related to their work (Vella and Gauci, 1997:29).
Audiometry is another type
of screening which is used for the early detection of any hearing loss; a
workers’ hearing is exposed to pure tone noise inside a sound proofed booth and
their hearing is tested at determined frequencies to determine if there is any
hearing threshold shift.
Biological monitoring is the
measurement of absorbed environmental agents or their metabolites while
biological effect monitoring is the measurement of the biological effect on
organs caused by the environmental agents. The measurement of methylhipurric
acid in urine is an example of biological monitoring for exposure to the
chemical xylene while the measurement erythrocyte cholinesterase activity in workers exposed to
organophosphates is an example of biological effect monitoring (OHS Act 1993, Vella and Gauci, 1997:29).
The measurement of methylhipurric acid in urine is an example of biological monitoring for exposure to the chemical xylene while the measurement erythrocyte cholinesterase activity in workers exposed to organophosphates is an example of biological effect monitoring
Step 4: focuses on the development of a criteria
which can be used as an action level (the level where action can be taken).
This is mostly done by using the biological exposure indices which are set and
provided by the American Conference for Governmental Industrial Hygienists
(ACGIH)
Steps 5 and 6: focus on procedure and method
standardization, ethics and the quality control
Steps 7 and 8: focus on the interpretation of
results including the provision of information and guidelines on how outliers
and abnormal results should be treated or handled.
Steps 9, 10 and 11: focus on the implementation of
control measures such as the removal of the affected employee from exposure and
the applicable legal implications thereof.
Step 12 and 13: focus on the work environment and
the control measures which may need to be implemented in the work environment
to reduce exposure.
(Source: Koh, 2003)
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