Exposure limits and medical surveillance in occupational health

The standards for pollutants in workplace air constitute a social consensus or agreement about acceptable levels of occupational hygiene. This agreement to exposures up to these limits inevitably includes a finite risk to the health of the workers. The numeric values of standards are needed to assess the requirements for ventilation and other occupational hygiene conditions. Planning and everyday practice in industry also need hygienic stan- dards so that practical hygienic and safety measures can be maintained. These standards are not, however, levels below which there is no risk to health. While the hygienic stan- dard itself carries acceptance of a certain risk, doctors cannot ethically accept any health risk to workers whatever the source of exposure. Thus personnel working in occupa- tional health have to think about the risks of ill health even when the hygienic standards are met. The physician in occupational health has to be especially concerned to discover and estimate the risks to anyone particularly susceptible to exposures within the hygien- ically acceptable conditions. To do this, the occupational health physician uses medical examinations and specific investigations. In the follow-up of workers, health occupa- tional health personnel use medical examinations in order to detect possible risks or to assess the general health status of individual workers. Health examinations are also used to detect specific injuries caused by the agents to which workers are known to be exposed in their work.