Document 4vyym9O8z00YgN2zLg8X28Lyp

`/\1 k'% Y '`a MEDICAL CONTROL i~-k X ROBERT A. KEHOE, M.D. CINCINNATI fi f I ^HE RECOGNITION of the existence of an occupational hazard, in terms of iVct& "* a specific occupational disease occurring among persons who have worked N*ss for variable periods under conditions in which they were exposed to known con centrations of a specific substance in the atmosphere of their work rooms, poses an immediate problem of preventive medicine. This is no time for assumptions concerning the nature and the means of exposure and absorption but is rather a time for the responsible physician to study the available clinical and etiological information critically and to obtain that additional environmental and clinical evidence which may be necessary to define the pattern of the occupational disease with respect to its loci, frequency of occurrence, severity, period of latency (incuba tion)--all of these in relation to the detailed records of the work of individuals as far as such work has been associated with any and all types and degrees of exposure. This, of course, covers the ground of the plant survey, which may or may not have been carried out by others. In any case, the responsibility of the plant physician for interpreting and applying such information is direct and immediate. Pending the completion of the detailed study of these data, in recog nition of the apparent extent and severity of the hazard, steps must be taken to protect exposed persons in every necessary manner. This involves holding a con ference or conferences with operating personnel and with all others who have information and responsibility, to the end that immediate, if perhaps temporary, measures may be agreed on and applied to the control of the hazard. This may involve a temporary shut-down in the operations until certain agreed-on changes can be made in the operating methods or the equipment or in the hygienic facilities. It may require that certain individuals be temporarily or permanently removed from work in which, because of their condition or the duration of their employment and exposure, they should not incur further risk. It may necessitate that personal protective devices (masks, respirators, air-line respirators or the like) be used temporarily, or in certain-circumstances regularly under such supervision as will make sure that they will be effective. The stringency of the enforced regimen will Dr. Kehoe is professor of industrial medicine at the University of Cincinnati College "of Medicine. ^/ 4 Read before the Section on Preventive and Industrial Medicine and Public Health at the Ninety-Ninth Annual Session of the American Medical Association, San Francisco, June 29. 1950. 165