Document gDM5bjNg5MeNdZgdQvyjmY5ga

OCCVPATIONAL HEALTH SERVICES turns vary m degree and can be serious enough to bar employment. The trained physician can frequently detect them during the preplacement examination It is not the function however of the phy sician to inform the applicant whether he is to be employed This is the prerogative and duty of management, as there are other fac tors m addition to physical qualifications that bear upon suitability for employment Periodic examinations of all employees may be on a required or voluntary basis If operations involved are nonhazardous, 2- or 3-year intervals can occur between ex aminations It is desirable, however, that persons past 40 be examined annually be cause some degenerative disorders show up around this period A required program should be appbed to workers who are exposed to health-hazard ous processes or materials, or whose work involves responsibility for the safety of oth ers, such as vehicle operators Substances like lead or carbon tetrachloride that are capable of causing occupational disease are usually subjected to process controls that will keep the workers safe from poisoning, however, caution dictates the advisability of periodic examination of such workers, to be certain that the engineering and hygiene controls are effective and continuing to be so This procedure also enables early detec tion of the hypersusceptible individual, and the worker whose personal unsafe practices defeat the control measures Frequency of the examination must vary in accordance with the quality of the engi neering control, the nature of die exposure (i e , the rapidity of the action of the haz ardous substance on the human body), and the findings on each examination Thus, ex posures to some substances might justify examinations or laboratory tests os a week ly basis, others monthly or quarterly, where as annually or biennially may be adequate m some dust exposures In many cases, laboratory tests of blood, urine, etc will suffice as the major portion of a periodic examination program, with complete examinations being made W fre quently The type of special examination (laboratory, X-ray, etc.) necessary for any exposure and the interpretation of the re sults are decisions requiring die most ex pert medical personnel Special examinations. Employees having on-the-job difficulties that may be health related are often benefited by special exami nations Job transfer may also require med ical evaluation Many organizations find it worthwhile to make "return to work" examinations of employees who have been absent more than a specified number of days as a result of a nonoccupabonal illness or injury This is done to control communicable disease, as well as to determine suitability for return to work There is a wide difference in the actual effects of die same disease on differ ent persons, and on even greater divergence of personality reaction to the disorder One person will go to bed at the first sign of discomfort, whereas another must be truly overwhelmed before he will fail to report for work When an employee returns to work fol lowing senous injury, occupational or nonoocupatronal, a new evaluation of physical capacities may be necessary Also the appli cation of rehabilitation procedures may re duce the disability and improve the range of employability. Exit examinations Upon termination of employment by workers, some organizations make examinations and record the findings, particularly where operations mvolve definite exposure to health hazardous substances, such as lead, benzene (benzol), silica, and asbestos dust, or to harmful noise A universal symbol for emergency medical identification has been developed by the American Medical As sociation (Fig 38-1) The object of the sym bol is to identify its wearer immediately as a person with a physi cal condition requiring special attention If the wearer is uncon Fig. 38-1. Emer gency Identificotion symbot. scious or otherwise un able to communicate, the symbol will indi cate that there are vital medical facts to be found on a health information card in the bearer's purse, wallet, or elsewhere. These should be known to anyone helping the in dividual struck down by an accident or sud den illness IK-<5