Safety_Series_025_1968 - gnssn - International Atomic Energy ...

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This publication is no longer validPlease see http://www.ns-iaea.org/standards/radiological hazards linked to their job assignment. In some cases,they may be trained in using the necessary preventive devices.Finally, they must be instructed in the usefulness of the variousmeans of radiological detection and methods of medical examination.The duties of the medical service can be adequately fulfilledonly provided extremely close collaboration is established with theservice responsible for physical monitoring of radiation. The medicalservice should indicate the general rules to be observed andrequest that the necessary physical surveys be carried out. It shouldbe provided with all personnel monitoring data and should also begiven such information about the general working conditions as willenable it to determine the extent to which work places are subjectto exposure and contamination. The closest liaison must also beestablished between the medical service and the management of theestablishment.In general, the activities of the medical service should be r e garded as confidential, concerning as they do data of a personal nature.This confidential character must, however, in no way beallowed to impede the improvement of working conditions. The importanceof health records, standardized in such a manner as to permittheir use for statistical purposes, should consequently be stressed.Furthermore, the confidential character of the activities of themedical service should not have the effect of obstructing the exchangeof information on the irradiation to which workers have been subjectedor on their state of health. In particular, if a worker changeshis employment, all relevant data must be passed on. The dose formularecommended by the ICRP applies throughout a worker's working life.The fact also that the latent period between the exposure and its pathologicaleffects may extend over several years requires that medicalrecords be preserved for an adequate period after cessation of employment,and that the medical service have access to them.4. 2. 2. Medical examinationAs suggested above, radiation workers should undergo medicalexaminations before, during and, preferably, after employment.These examinations do not differ basically from those carried outin industrial medicine, but reflect certain specific requirementsresulting from the special nature of the work done by the workersin question.102
This publication is no longer validPlease see http://www.ns-iaea.org/standards/4. 2. 2. 1. Medical historyEvery medical examination should begin with a thorough inquiryregarding the family, personal and occupational history ofthe worker.4.2.'2. 1.1. Family history. Family history is of importance becausegenetic disturbances are a significant part of the possibleeffects of irradiation. Particular attention should therefore be givento any history of hereditary, family and congenital diseases, andit is also useful to know the incidence of cancer and leukaemias. Theinvestigations should relate to ascendants (parents and grandparents),collaterals (brothers, sisters and cousins), descendants (children)and also the spouse and his or her direct ascendants.4. 2. 2. 1. 2. Personal history. Accurate data on the w orker's personalhistory are important, facilitating as they do an evaluationof his state of health before employment. Care should be taken toinvestigate all disorders which may have affected organs or organicfunctions that are particularly radiosensitive or liable to damageas a result of work with radiation. The investigations should thereforebe made to bear on haematological diseases (anaemia, granulopenia,haemorrhagic disthesis), skin diseases (dermatitis, dermatoses),diseases of the digestive tract (acute or chronic), diseasesof the lungs (infectious or allergic) and diseases of the eyes (cataract,conjunctivitis).4. 2. 2. 1. 3. Occupational history. Finally, the w orker's occupationalhistory should be carefully noted. Injuries at work and previousoccupational diseases should be recorded. However, the historyof any work done with radiation or with radiomimetic toxic preparationspresents the greatest interest, and any occupation involvingradiation exposure and, in particular, any cases of over-exposureor radioactive contamination should therefore be faithfully recorded.Previous work with benzol, other hydrocarbons and all other carcinogensor mutagens must also be.carefully noted.4. 2. 2. 2. Examinations4. 2. 2. 2. 1. General examinations. General examinations shouldbe such as to give a proper picture of the worker's state of health. A103
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26Table 6-2. Fracture-specific EC i
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