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/medical examination by a suitably qualified physician at or shortlyafter the termination of their employment. Depending on the resultsof this examination, it may be necessary to provide further followupcare after employment has ceased.The follow-up care would not of course include monitoringexcept possibly in cases of significant body burdens of radionuclides.It is generally desirable that it should include some type of medicalexamination intended to detect late effects of ionizing radiation.4.3. HEALTH FILES4.3. 1. GeneralWell-organized supervision of workers exposed to ionizing radiationis inconceivable without systematic and accurate records ofall the data yielded by physical monitoring and medical examinations.The data in question are, of course, those relating to the individualworker himself. Consequently, readings obtained from environmentalmonitoring (environmental radiation, contamination of airand water) should not be recorded, but all data on exposure of theindividual (film badge and electrometer readings, skin contamination,internal contamination) should be included in the worker1s file togetherwith the results of the medical examinations undergone.These data constitute individual health files which must be kept underconditions of medical secrecy as defined by the competent authoritiesin each country.The health file consists of: job assignment and occupational hazardsheets, from which can be inferred, in respect of each worker, theworking conditions to be established and the radiation and contaminationhazards to which he may be exposed; radiation and medicalfiles containing ali data yielded by physical monitoring and medicalexamination before, during and after employment; and, preferably,a separate register of occupational accidents or diseases. All abnormalexposures should be recorded together and clearly distinguishedfrom normal exposure.4. 3. 2. Job assignment and occupational hazard sheets4. 3. 2.1. Job assignment sheetEach w orker's file should contain a record of the posts heldby him, and it is therefore useful to introduce what may be termed114
This publication is no longer validPlease see http://www.ns-iaea.org/standards/a job assignment sheet. This document is started when the workeris recruited for the first post held and should indicate all changes ofpost. Such information is basic and if it is desired to determinea worker's contamination level by the indirect method of calculatingfrom the pollution level or each work place, the time spent at eachjob must also be indicated. From the administrative point of viewthis may entail a considerable amount of work and a com prom isesolution must sometimes be adopted. However, it is the only re latively accurate means of evaluating internal contamination by deductionfrom the working conditions.4. 3. 2. 2. Occupational hazard sheetThe job assignment sheet should be supplemented by an occupationalhazard sheet providing information on the hazards of externalexposure or radioactive contamination involved in each operation.These records should be kept with great accuracy, as theyrepresent the only possibility of establishing a causal relationshipbetween occupational activity, radiation levels and the w orker'sstate of health. The occupational hazard sheets should be suitablyamended whenever the working conditions change.4.3.3. Radiation and medical files4. 3. 3.1. Radiation filesRadiation files should include all available evidence for evaluatingw orker's radiation exposure or contamination.Before actual recruitment, the radiation files should includedata on previous occupational exposure and, as appropriate, on otherconsiderable non-occupational irradiation or exposure to radiomimeticsubstances, together with a statement of the level of internalcontamination where this is thought to be advisable.The principal entries to be made in the file during employmentare a record of the physical monitoring results. They should berecorded in such a way as first, to facilitate summation of the dosesreceived from external exposure and radioactive contamination, andso make it possible to determine the dose accumulated after threemonths, six months or a year; and, secondly, to enable one to determineat any moment, by means of a graph, whether the dose receivedin the course of the preceding quarter has remained within115
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