A discussion was presented of medical screening programs which often complement environmental control measures. It was observed that a well designed medical screening program should benefit both the individual worker through the early detection of disease and also the group of workers who share common exposures and risks. Screening programs were noted to typically use tests developed for use in medical practices. However, individuals who feel ill have been observed to submit more readily to some of these tests than workers who feel in good health. In workplace screening programs as well as in the community health screening programs, screening has often been a primary means of targeting for subsequent action. Recently OSHA issued an advance notice of proposed rulemaking for a generic standard for medical surveillance. NIOSH expressed support for their concept of a generic approach and has currently been developing comprehensive guidelines for transmission to OSHA. These guidelines will include a decision logic that can guide medical screening programs, standardized protocols for evaluating certain screenable health effects, and policy recommendations on generic issues such as confidentiality.
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