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Safety_Series_025_1968 - gnssn - International Atomic Energy ...

Safety_Series_025_1968 - gnssn - International Atomic Energy ...

This publication is no

This publication is no longer validPlease see http://www.ns-iaea.org/standards/4. 2. 2. 2. 11. Neurological and psychiatric examination. The effectsof radiation on the nervous system at relatively low levels aremainly functional. Low-level irradiations may, according to someauthors, lead to certain disturbances, the transitory nature of which,however, makes the practical application of functional tests im ­possible. In the case of whole-body exposure, nevertheless it maybe of value to study the electroencephalogram for neurologicalchanges.Neuro-psychiatric examinations are also very useful in assessingthe suitability of workers for responsible posts where human deficiencycould have serious results (reactor or accelerator operation).4. 2. 2. 2. 12. Biochemical examination. The purpose of biochemicalexamination is to study general or particular changes of metabolism,especially those more or less specifically connected with ir ­radiation. The determination of the main characteristics of theblood or urine is of relatively secondary interest, except as regardsurea excretion and for very high radiation doses. On the other hand,the urinary excretion of amino acids is highly important, any significantirradiation being followed by an increase of aminoaciduria,and it is recommended that the nature and quantity of excreted aminoacids be determined by chromatographic analysis. In cases of overexposureadditional amino acids appear and the quantities eliminatedincrease significantly. For certain amino acids, such as aminoisobutyricacid and taurine, the quantities eliminated are to someextent proportionally related to the dose received and determinationof them is, therefore, of some value. The normal aminoacidexcretion rate should therefore be determined for every workerliable to significant over-exposure and the actual excretion ratechecked regularly. Since aminoaciduria can be a constitutional abnormality,it is not possible to draw any precise conclusions fromaminoaciduria discovered following an over-exposure unless thepreceding levels of amino-acid excretion are known.Enzymological and other biochemical examinations may alsobe performed on the blood but they still belong to the field of r e ­search. Immuno-electrophoretic examination of the plasma, onthe other hand, may have real value in cases of over-exposure.4. 2. 3. Organization of medical supervisionMedical supervision should be organized in such a way as tomake it possible, in the case of each worker, to assess beforehand108

This publication is no longer validPlease see http://www.ns-iaea.org/standards/his suitability for the type of work to which it is proposed to assignhim, to keep a regular record of this health during employment and,subsequently, to intervene in the event of any late occupationaldisease.4. 2. 3. 1. Pre-employment supervisionBefore any worker liable to exposure to radiation is engaged,a report should be established to serve two purposes; firstly, toserve as a basis for determining to what extent the past history andthe present condition of the worker make it possible to regard himas fit or unfit for the type of work for which he is being considered;and secondly, if he proves fit for such work, to serve as a referencepoint for any subsequent changes due to the hazards of thatwork. Every worker should therefore undergo a pre-employmentinquiry and medical examination.4. 2. 3. 1. 1. Medical history. As explained above, the inquiry hasthe purpose of determining the candidate's hereditary, personal andoccupational history. It is of particular importance that all previousirradiations be noted, for which purpose an account shouldbe kept of external exposures and an attempt made to obtain as muchdata as possible on any radioactive contamination. A gammaspectrometricalexamination may be useful for evaluating as appropriatethe present body burden of gamma-emitting nuclides. In theanalysis of previous exposures, a.distinction should be made betweenthose due to work with radiation and those due to radiological examinationor treatment. The former must be taken into account later,during employment, for the assignment of maximum perm issiblecumulative limits. The latter, however, should be ignored whendetermining the accumulated dose, although they should still be carefullynoted. In some cases, especially after extensive radiotherapy,an additional occupational exposure might seem inadvisable. Onlythe medical officer, however, is qualified to determine to what extentsuch previous therapeutic irradiations are compatible with subsequentwork involving radiation hazards taking into account the environmentof work as well. Any possibility of previous poisoningby radiomimetic substances must also be recorded. Although itis difficult to establish a precise relationship between the effect ofradiomimetic substances and that of radiation, there is no doubt thatprevious poisoning, especially by hydrocarbons, may be a factor1 0 9

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