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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/in not allowing a worker to engage in work connected with radiation.In this respect again, each case must be considered individually andit is for the medical officer to decide to what extent disturbancesdue to chemical radiomimetic agents may contra-indicate subsequentwork involving exposure to radiation.4. 2. 3. 1. 2. Medical examination. Taking into consideration theadministrative classification of workers (cf. section 3.2.1), com ­plete medical examination should be carried out, preferably notmore than two months before engagement, and should comprise, asexplained above, a general examination comparable to those madein industrial medicine and special examinations of the most radiosensitiveorgans. The former indicate the candidate's general fitnessfor employment, and the latter aim at determining to whatextent he is fit for the special work, involving a risk of externalirradiation or radioactive contamination, upon which he is to be engaged.The special examinations should therefore be specificallyadapted to the kind of work for which the candidate is intended. Thefollowing remarks may be taken as an indication. If there is to bea risk of significant whole-body exposure or general contamination,a haematological examination should be made. If there is a likelihoodof exposure to soft (beta) radiation, of skin contamination (alphaand beta emitters) or of actually handling radioactive substances,a dermatological survey should be made, supplemented by a carefulexamination of the hands and fingers. The risk of atmosphericpollution by radioactive substances is extremely high if unsealedsources are handled and in this case, particularly if pollution byradioactive dust is involved, an examination of the lungs must alwaysbe carried out to reveal any morphological changes and tocheck the functioning of the respiratory system. If the work involvesexposure to neutron radiation or heavy particles, the condition ofthe lens should be determined by ophthalmological examination. Itis therefore necessary for the medical officer to have at his disposalan occupational hazard record, as described below.4. 2. 3. 1. 3. Decision regarding fitness for work. The medical historyand the general and special medical examinations should yieldconclusions regarding the candidate's fitness for a given type ofwork. Candidates are classified on the basis of a number of c r i­teria, the choice of which is an extremely complex matter. Definitestandards for judging a candidate's fitness are highly desirable, but110

This publication is no longer validPlease see http://www.ns-iaea.org/standards/as yet no such standards exist. Blood-count values are those thathave been most generally fixed, but they vary from country tocountry depending on geographical, physiological and biological conditionsand on the techniques used.Summing up, it must be borne in mind that each case has tobe considered individually and that the medical officer, and he alone,is responsible for determining whether the man is fit for a particularjob. Poisoning by radiomimetic substances or excessive therapeuticirradiation may give the medical officer grounds for hesitation r e ­garding an individual's fitness. As far as medical examinationsare concerned, it is impossible to define quantitatively the limitsbeyond which skin disorders, morphological or functional changesof the lungs, slight abnormalities of the lens, etc. should contraindicatework involving the risk of skin contamination, atmosphericpollution or neutron irradiation respectively.In all cases decisions must be based on both the medical historyas a whole and the results of the medical examinations. Candidatesare, as a rule, classified in three categories: individualsplaced in the first category are considered fit for work involvingthe risk of external exposure or radioactive contamination; thosein the second are considered temporarily unfit for such work; can-. didates in the third category are declared permanently unfit. Personsplaced in the second category should remain under medical observationfor a certain period, during which further examinations arecarried out to determine whether an improvement in their conditionrenders them fit for the employment intended. It should bestressed that a final decision. of unfitness should only be taken afterseveral confirmatory examinations. Conclusions and decisions shouldbe recorded in the worker's medical file, as described below.4.2. 3. 2. Supervision during employment4. 2 .3.2. 1. General. During employment, medical examinationsshould be carried out at regular intervals. Exposure or contaminationmay in fact sometimes easily remain unnoticed and, consequently,efforts must be made to detect any effects. On the otherhand, changes in an individual1s state of health may occur whichmay seem to be due to ionizing radiation, but are in reality due toother causes. Even so, they provide a reason for taking the individualoff any work involving considerable exposure and contaminationhazards. All these factors therefore point to the advisability of re­111

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