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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/gular medical examinations during employment, their nature andfrequency depending, of course, on the occupational hazardsinvolved.4. 2. 3. 2. 2, Nature of the examinations. It has been explained inpreceding paragraphs that these examinations should comprise generalinvestigations supplemented by special examinations of theorgans likely to be most affected by external exposure or radioactivecontamination.In usual practice, a number of examinations have to be madefor all workers submitted to ionizing radiation. These are generalclinical examinations. Others should be performed only when theradiological hazards so require. The following cases may be mentionedas examples.In case of whole-body exposure to penetrating radiation or contaminationof the organism by radionuclides that are distributed generally,haematological examinations are recommended becauseall the blood-form ing tissues will have been irradiated.In the event of external exposure to radiation with a high linearenergy transfer (LET), especially in the case of irradiation of thehead, ophthalmological examinations should be undertaken to keepthe state of the lens under regular review.In the event of contamination by radioactive dust, as in uraniummines or certain workshops where radioactive substances arehandled in powder form , examination of the lungs is essential todetermine the condition of the pulmonary tissues.In the event of contamination by kidney-seeking radionuclidesor radionuclides with a toxic effect on the kidneys, the morphologicaland functional condition of these organs should be kept underregular review.4. 2. 3. 2. 3. Frequency of examinations. The frequency of theseexaminations will naturally vary. In many countries the minimumis one examination per year. The optimum frequency depends ontwo factors. Firstly, the occupational hazards have to be taken intoaccount, as regards both their nature and their extent. In this respect,the occupational hazard sheets referred to below play anessential role. The extent of the hazards may be judged from theresults of area monitoring of radiation and from the level of radioactivecontamination at the work-place. Secondly, the frequency ofexamination should be governed by the state of health of the worker112

This publication is no longer validPlease see http://www.ns-iaea.org/standards/concerned. In the case of workers in whom a particular organ showsmorphological change or signs of functional disorder, the examinationsshould, of course, be carried out at more frequent intervals.4. 2. 3. 2.4. Abnormal exposure and special examinations. Workersmay be exposed under certain circumstances to doses higher thanthe MPD recommended for normal practice. In an emergency exposurethe exposure is voluntary, while in an accidental exposureit is involuntary. The International Commission on RadiologicalProtection visualizes that in either condition it is unrealistic torecommended dose limits. The ICRP and the IAEA Basic SafetyStandards for Radiation Protection [14] also indicate that the dosesreceived in abnormal circumstances should be recorded togetherand.be clearly distinguished from normal exposures. If the doseor intake of radioactive material exceeds twice the annual limit, thesituation should be reviewed by a competent medical authority, dueaccount having been taken 'of the person's previous exposures, health,age and special skills as well as his special and economic responsibilities.It must therefore be emphasized that the magnitude ofthe dose received by an individual and the implied risk contributeonly one, although an important element to the assessment of thecircumstances which would determine whether a worker should continuehis radiation work, if he has been subject to an exposure inexcess of the appropriate maximum permissible doses. To be ableto assess the w orker's fitness for further work, examinations,additional to the foregoing which are appropriate for normal workingconditions, may be necessary. In the event of an abnormal exposure,special examinations must obviously be carried out to detect anydisturbances and find out as far as possible whether there are anycorrelations between the accidental irradiation or contamination andthe clinical symptoms.Whereas such far-reaching investigations as myelogram studies,chromosome or lymphocyte abnormalities and tests of liver andkidney function are not appropriate in normal circumstances, theymay be very valuable in the event of radiation accidents.4. 2. 3. 3. Medical examination at termination of employment andpost-employment follow-upAll workers who have worked under condition i (see section3. 2. 1, administrative classification of workers) should undergo a113

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