Document a4Zwm0wYkwVGE6RVwaQZGa4eB

22 RUTH B. TATTY states merely that John Smith was examined on a certain date. If the card returned to the personnel department and thereafter kept in its files is green, the man is physically suitable for any job in the plant. Should the card sent back be yellow, it means that the subject has some defect or handicap that must be considered, and the personnel department is required to discuss the proposed job with the physician and medical department to determine whether .the individual may fill it without harm to himself or others. A yellow card in this man's record also means that he may not be transferred without consulting the medical department and obtaining its permission. A man may have a yellow card just temporarily, until some defect is corrected. A red card is returned for men exhibiting serious conditions, such as complicated silicosis, heart disease, and uncorrectable vision deficiency. Applicants getting a red card may not be hired except for work in special nonhazardous situations. Old employees so classified on surveys are treated the same as men with yellow cards and some position is found compatible with their condition. The usefulness of an industrial hygiene department is greatly augmented by close collaboration with the medical department, mainly through comparison of records compiled by each. Where an industrial hygiene survey shows high dust counts, comparison of results with chest studies, particularly if there are employees with long service records in the department, can help in determining whether the condition should be attacked as a true occupational disease hazard -or-as-ar-nuisanoer-I-f--management -is-approached-with-all-the-facts,~.hyster-ia- is- avoided and better confidence is fostered. . Similar situations develop where medical findings can be elucidated by consideration of industrial hygiene findings. An example was the finding of a high percentage of chests that appeared silicotic in an x-ray survey, but in this case the dust'counts were only moderate and the free silica concentration was very low. Further study showed very high concentrations of iron oxide, mainly as fume too small to count, from welding and cutting operations. This pointed to a diagnosis of "possible iron pigmentation" as described in the work of Sander.2 ................ ......................... aja-RSE's,,BE.co.aE>s.1_____ The plant nurse^firecords are of vital interest to the industrial hygiene department. Every' enrpl8ye<ji'i yjsit to the nurse, whether for actual injuries and re-dressing or for dther 'coffipiaints, such as headache, cold, or sore throat, should be-recorded"and"`recapitiflated 'by department each-week--or'-mont-h.-A critical review of these records by the industrial hygienist may uncover a previously unsuspected atmospheric contamination, such as carbon monoxide from a defective flue, giving rise to an unusual number of headache complaints from the area affected. Even more obvious is this review as a means of picking *0. A. Sander, 3. Ind. Hyg. Toxicol., 26, 79-85 (1944). mm- i3l INDUSTRIAL HYGIENE RECORDS AND REPORTS 23 ,,it... . new sources of dermatitis, for as soon as a material that is an active skin ,, , -^irritant is introduced, the nurse will be deluged with complaints. In such acute Ifjy .$*>!. ^ Conditions the alert nurse will call in the industrial hygienist before the situation ' " '.has-gone very far. S8Sijp||fek A medical records training program for nurses in one large industry consisted )jof the following seven sections. It shows keen appreciation of the importance of /.paving records of the highest possible quality. ; > Unit 1: The Importance oj Concise, Neat, Accurate, and Complete Reports. An attitude ^^^gi|building session aimed at the development of a greater appreciation of responsibility for and "3 isSiV' ; importance of good medical records. S| Unit t: How to Get the Most Out ojl aan Interview. A Bession aimed at developing a better liW ^ |ulimnd^nepraattnann/d^iinniTg rotff +thVwe rptpriinncniipnllaeas oannJd ttaencVhinniiqaues of conducting an effective interview. Unit 3: Conducting Better Interviews. A series of sessions designed to increase interview- |&king skills in realistic, local plant situations. ~ JS&sl ^,6v^evJ f Medical Terminology and Anatomical Locations. A session or two conducted by the doctor aimed at refreshing the nurse's knowledge of medical`terminology^ *&nC* ana^om*ca^oca^ona' , gJlxjt, - ' Uwinvhit, v6.; iHiuoww'tiov nPvroppveTrly Record Data. A series of sessions devoted to a study of the Ideal plant forms and proper methods of completing these forms. 'ii-ftSti ' i .1' Unit 6: Recording the D. ata. A series of skill development sessions designed to aid the dnu._r_s__e__i_n____c_o__n__s__is__t_e__n__t_l_y___p__r_o_jd.u. cing high quality medical records, is V* Unit 7: Evaluation and Summary oj Program. A revviiew and summary unit aimed at aiding the nurse to develop a continuing program of self-improvement. uasm rFv. 1 D. RECORDS OF BIOLOGICAL SPECIMENS When the effect of the environment is measured directly, as by analysis of 'i Pt Ur'ne eamPles for Jead> a means is provided of correlation of studies of the ^t-^oiment and of the individual. The following is a description of such a survey s&'Sjjjji. made in a program for controlling the lead hazard in a brass foundry at some '.7[i^j^.Vh|tance from the industrial hygiene laboratory. v " ' pot BamPles were collected in the first-aid room hi the plant, and the card in Figure 3 was filled out and fastened to the bottle with a rubber band. Lt;4^LThis card is the result of simplification after first using a three-part slip that .ad -to be filled out with two carbon copies. The first form was abandoned Juse4t-req!U;iFeid-rtpo-much-tiffle>onAthei part of- the-pliffifipersonnebAhd-was not understood. It also required for each sample collected filling in information w^''U>akt was already available to the laboratory even when the firfet,.sample had been ||llected, such as the age of the individual and his working'^fSce. Also'it had jafeSft-paces for-laboratory data, .which were not, pertinent to .the Rhsle. .of the. survey ^jp-made at the plant. 'Ilfi Simplicity and explicitness must be the keynote of a form such as this,.which i?-is'to be filled out by plant personnel. Use of the term "Urine Wasted" had caused gspme confusion; therefore, the explanation "Urinate in Toilet" was added'. fThe llppose here, to obtain a record of all of the urine excreted by the kidneysefor J^definite period with information as to person, place, and time, is the one And j^SRPiily function of the card. '- fi m