Document nk3VYjzxoYbjKqMBGajqEv882

fj LEAD INDUSTRIES ASSOCIATION O EAST 4Ih > STMCET N(W YOM 17. H.T. September 30, 1957 ISXh HD DJig and sxrrrr B'jugria Ho. 126 To it* tieaber* of the Lead Industrie* Assoc latlonj S tastnr or *iDri Last referred to la Lead Hygiene And Safety Bulletin leaved on June-20, 1956, the drug *Eri* (Edethanll, Bullapcn, Sequestrene, Yereene) continue* the outstanding choice of the aedlcal profession In the treatment of lead poisoning. Erl dene t that the drug was being claused led the Aeerlean Uedlcal Association to is sue, In 1955, * earning on this acore prepared by Esr, Robert A. Kehoe. 3uch alause appear* to continue In son* quarter*, and we hare accordingly reprinted this warning report, by permission of the A.U.A., and a copy 1* herewith. Particular attention Is called to the closing sentences of the report. resiru ECAiaxATiats Wide variations In policy In the natter of pre-caploynent and periodic nodical exaslr.rtlcna arerg cur ne-lar companies have led us to secure a supply of the current publication of the A.l'.l. on this subject, Rjuldlng Principles of Medi cal Lcanlna tiers In Indu atry, and a cojy of this la also herewith. * o p i?cram t o w ir wane revests The C. 5. Department of the Interior has recently issued, as Bureau of Rln*s Information Circular 776?, a 2li-page publication elth the title *3141* Regulatlors Pertaining to the Use of Interrwl-Coaatustlon Engine* Underground.* This Is erallabl# froa the Plications Section, U. 3. Bureau of tines, WOO Forbes 5t,4 Pittsburgh 13, Pa., without charge. llaniYed Bowditob Director of Health and Safety ; r \ t. $ ............................. ... :+.;y IIf w- inr*s#`;*f****<--*` LIA10978 !4 t ** #//) /to Ja--arf (/ *4# 4wir WM rt tip wittftkioo t*f pKiktl iinna kr (hr t*f corffoM A~m*+--+ )**>' U. /*n r4 / ^ mi that art to hr tihioff Vtkt hr Utit to to <rd%#td *4 to to < /*1| Af 4` -* Wad* to A (AtofttrtKr cw thr toont of tlrtutu coottcf of fipoturi to tr*f tor lo othrr oiupiiKMul ht/pfil. hr tonofton to (he rnkt to ah*h ftvoiiwft toe wSntcd mf kumo a pari) to ikr ciH'-rncr. i i COUNCIL ON INDUSTRIAL UK ALT U t.ND COUNCIL ON rilAKMACY AND CHEMISTRY Thr ft*.'uft of (Sc frapdtf b o w m of nhitoml ttktva* d'ftnj'woi a (hr p U do<) of MMti opmuiik pffkttM of pi*r>ilfc.tk (hrrapr t r>4 hrW lr^Vn AMrraf# or thr pad of fi-itMiM **to iHkn to it *i| ir ihc rfM of (vrrrto r(#*>* ftt^nf^ato of lead ty uaduortal trorknara have bet* ftrirrrowi W.tk.1 IftorM aod.* IftUOHft a*4 pftr|U*f\ ft*f rff^Aftit f^f/aftd h aif* hl* tof tkR pOpMMtlK. 4 M Wmh Ik* prrvorto m^vt Po miw to (hr proardtov of dto RlTORT TO THE COUNCILS *1lLft(wa` rf W>4 it thr tirkwa rtfomt. teOrf prfwdKaR). to tome (h i'i ma . h proph)t*u *iftot)i/*tM* Jkf C>< if m HrmJlk 0*4 14/ Coaorff od of toad Iron the airtoto*.' oar totrf pa the iHiifft(uai of Ato **f hi iMMum* Imm of dr toftfWijim n of thr : / |4< *Vf*+1. ft**** / <*l fWaifri4 H**hkC**4 V htlttuh, MO, intrlarf. wkdi of iftl)vi totoUHr at (hr irtr. ito IrJ to thr ouvato* kkf that thrir (fpmf tfnii on thr head MtfthfMM tatff hr fMtf hy ikfu mi the (ikNM mruMna to (hr uvrryotd**| drtvTiori That ihrr and uthrt it--fftttkt cwikuH. tok RT M O, hft*T krft toifkitf to pifhtlaift land iwtltKi therapy, in C*w %/ iMI <mU fvMiy, tMrkftni MrfrdtwJ' m hector (he puM 1 hr fatt m that the) Of t>4TH4MH f AU fTM DfMHWM ot ofifft iMf m ton of iSr tfrowr mrnarn of r*Mto< iMil (ha* art Stated hy h mu Jit h o m of aovaJ to* i o k munnuxn o u a o rvtsoMsc diaMrul h||<r aaJ hy dnri itpatf lot thr %*Uty and attfur of tom* kwfi |i m to hr tytoaf (hat Htlvoul rurnfunraa RttArri 4 i/W, MD. flomil fthofttof fiH and hr a)d) Mftpn i*rd h> th m+jtc of oo^to aad iitoith imftawH orfid pn^kitotK (mokm Thr dui kn f*TrJ it Ank^mrM of a w ia !# VY of f4(kaM| K kiMi t>nW Vi<v*W. Kid, I OTA) lot lr*aJ a |4f of IraJ a a 4 Ito meat Ronl <W n^nifwl (k ] np>vt (twcTMi| 0% mm. Imtttth tfk 4a t< klrtiAn* iW |As u >u m trf/4ic oca tacam *W rVo*iM| umM )n<w nJ ^nirrit 1W Ake Imn **r iw ih< Im that ihr MSMkivf of (M #f< mM t2<irkW O oodwfy tufh, dr^MW the MAiUNit) at adr- ^.1 f*J fwai*.*j mrtHuth lot (hr rT*i'Tttr-*,e ''d tncdud of i r c4 k*d hy loAwcftrt ffwftntn *nd r*Set yn-WH m tK< |t h M h n w im lamWdff rathrt thaa (at (hr tarra and tftrt ttoh M^nam of mU rtfHCtft 4r*a* or aa.xvaOt pUar wptotM^ If a r^iMiM. hraddy ho^aJ to* prvfcftw**! pfiktocc. W| hrar thr rnppootolry for (he (Vraftrard fwahh of wtoortof Miaay mftftrttt iM wlr^ad a fWtt. mt toad mmkM (hr la.it of U4 pit/iUt them *a th La of thr ttaarrM of tofkwft oJ toftn to (iurptaiaior k mi Ik otoaftif*ica hy pntt ottM of (hr ifpiyntit toll rf f jartift*i4. a MMuto nh many 4 aa aP nT nek imOmI wa**ar* of pit*'Uii ftifiMf aod i ^4>k i1 Ml thr pod, odrt* itntd o<iinM>r piwpo'i tor tororVttf rfr.K ft* ^ to fctor*f lok toartov *mmVt iffHfttot iftfrmatili. to tVl i*<Tf 4't h i l *>nJ <nr UvvwMtit of and 4lavn*vi hftNdft. oad tM.kf imu m (atfftQf had trfKL<p(h w*M#n atwoto tkfUrrd if to ^ )t#rt ad o|kf (vtiMMiatfttx r*t*iaaSy may hr friiad to to |f> p <fkl iK4 lhr nuriolN* of <i4mi i Sm i o ImmiMi tfiifwWJ. few* .,,J 1 *t #* oVfi*UK ihto 4ftr>ft|nan Ook carHtd aod lSm|k untryftta>t. torartr*. a dnrttaMM atothrt tto* m fi*Hr. aod ahcfhry h< mo o miV Ht'Oitf pfM Mnt Miwin Kj *t iff hrm drxo'skf h J J 1k<rf v krt*fW. M pnlAtltMi for tkf lrmwv>>T aufc wfcavfc o Nw u Jt ku/iliv mw )v mh a | r/*<** j t c lo had pfuVi. i** fr I"hr ftdvff rf Hiivitry W* coipAoy rM ) dMv to lid hi--aoa w Oimp. M A OdH Mto iMi ftc > *( I *rft*ia> hm l*IJ. M 4, a dj <*>- aa| II*. (MIM ftftd W--* N ft4ft ft. a r^Mm r I Id h I a to a in in iWh ]. mi iSi hot U>hr<t luj*Mlvirt tip**wt to fn*M i Rift** M * . < -o*t a ot UH( t I Th MmI rf Er Mtait^rtW (ftftdoM IWm *rr w|ii iht rtibrJitl ifftit. ^Lh Iu a ii) iakaMOckwahutoi. ouy ^ (ooftMiJ a*d prthf>* 4*+y rtJetd ha Vftftftao c ft* ld Racfti I I * 4 (to tor* t4< III4IIT (top I MW t*Mft r to. orwa* a ir .......... * t*d a%ao IM I .!* a AnH a ( mj mSd k * of fvit fj*A*<wo of the f***nMM of p*te**f I 4ft* t I ft-** <- ft a*r aft--*ft-d 9 to<.>* (t how iMp lor itwt rrtvMi |*4u,an mat artil to k i*nJtf of \i thr rok if pmO'w in v Imim a thr t**d bifrt *J of (War T>***-'Mft a ** T*.-ftftft T |*r ftiMwfthftia I d ' aNMtli;in*,4^.!ii; kfftM ft I ( I--ft <M I ftl I 1a *to a-ft- | a w a tftL^.'itiM tr. h Va f fwO o krrp thr for thr trftij erf N | M ft--*.'** ted*.I toad V . t'to* iHft. t lto t^Mdl I I (4 rAtKtMMiM*) n ihr h*tk of Mk Iv iio *| mHUpnww ki a Ml Wftfi *m ftarto**. /#*riftOC t (ii*ti0| kk>rt thr ftMr hy n lift Mr (f Ik lr*f w| 't o m**-t - ffcv*, abf* Ihr f*h>v*i*A M todotofy > ito ltd AJft-ai tan * A* t ( tVd | 1 . 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I 4*ftM>*** **d ft >.lift* ftd ffta* ftftftM W s M ktor t (MM.ftft.ftft < I *to Min i ^ i ta i**o M lr af i i v <w**a* *, |ri.jn -t . f.,.-- T t**d P--** $ l*d--I d*f A (** a . *1 *1 lift* I ift. > * --v a 4 14*a# to Iaad l**ftftfti I A to a ia->4tt itoa*A to* tra ' --'i.. uuwipiaitifftS1 '' N 355.01 LIA10979 l m t***fkiftJ f*t* ew*ti|K ta tW foftg nm, mt u m prafK^m I* Mult!) M Kt (tobtiMrf jftftly Kf k* *0- t at Mi ih . min*tf(K> by mmOv ftftrf well prrfBrftttoft I* ***4*H fat If bn hMi (M lainmov* M VatrmmtaruU# uni a4 al*rtAf*4 uWwn^MuJivtn, i U*ut#4 u ma b * tnc *n <)m p\*rorf Tbv* mwW be |<>r to Utouttru) emf>kyw* ft iOotft UKOfvtiurAt or toy**!*** o* ibctr pert. ft*rf mi foe** irvrf o hrwf f**r**Ai to tfrx. it *a e--*iUy ufi r*t*d* Arnrto tk*i m-avij ftut K(o* (h*l * *nr*W`ftb*l S/A*Me (brrft^y Vft* Tb*i a (M br it)4 bM M twfi on U* It* erf rm^u*Tv at foe k* boi M * kfU h>k(M^ by dvta fcoAj rmflujrf JV< Kr*rfii ( if*uhi lK*t lit luftfi to fuflow vha lift at ^h * pfrxrJw ftoHilrf M Oio*# erf <o***erK4# l4 %< V) i!iwt rfvrtr* efr%4 o* mart frf&k**4 pftv^i at MK*( **rf pmr*:**lly Wthkl W4 Wmo *k *?*o a * It* tolOTft, r* * * (S <m*.a 1) t*w rf rc.frtoft erf W%4 rf Irf U'u m erf m ipMMftKrf rrrffttu*. m (ornpwrf ftftb (Sat Armntorf erf MrtiW>, M ft* |p(Wt |l c w r Kj m* *>tfc trad Mi it* krft twun erf (S* bprfr. far--** tuNt, ftrfvHe. *(im*u *4 tpAiftmfrf haMf erf ibr rtfrf furtinn* rf Ibrt (aofowrf. pnfcifUIi h ft*j erf f)W trfftf, ft ftfkrxt^f oOw-^*M. h i the (OTkeru/ftiftto <rf M*rf to ft* oft ti--Mt Mwim/. th aimorjatam erf tSe Arv| from dH Al*ff*eft*f^ i/ftct h iCftftfk*/Ara)) poor '1 iSm fi r<ftVrK at * *1(bSa to fio4ef* iotttft* to (1* WAft) rumtoa irp tr*rf frpi d* mV> (h *v * '*, Koorxf. 0 erf irftd.'* iSr * b Uo rrwVm* *MiftAito4 cKkftj dw* iAcrrM w 9h Mttt-W to pc*<ir*u mia IN i^fbrwywt TVfrfoft, Oft occur* to **Mc ftieo .<K * corff*to4tof M<ft*i( M tlw OtftfM W*4 or*.4A*'ft'o* * tbe Hoorf H Cft* ft* toW**rAl>r of W*4 froft* do *luiK*f) tract " l rK*e n, Om cftrf-fr*tl urf *Kevf*l) ft H ftfwi Dm ftiAitftaftrfttioft rf 4*Mn*prv4 (Ml.) " 1M 4<**dt erf (fee K*Mfteil p(M ftftd Kl WHOM *Ik u m* m tWto to (Met u m *ftl ftMM k> W rft*M*M a* 10 rtf^ tr 0* rtftMWo* erf IrW frcao ft* bo4f. f *te rf tt* ihouirf t* ft*** c h t h iII Uc t v m m (M nH W cltowAftiioB erf lr*d. rt* owMitir* erf W*4 totrftrf. to rrUtno b) utnnftiM TKo (k tfftul uf*A*ft(. *o Oft lo (S( tor*] fMftiiin *Nto(J **f to tbt torf) itfwVr Ittw lA U1t Mbn o<eU att uln oft erf tb* M) for (Kft mwf. cfeft fvvi'fftrtl *jtfliftr>2KM erf O4 0/u|. ota Mftf* Mftftt}, ft frftwffe* ! werfftea* pakwoteftt lot Oft wot erf ft* Mml wuMnA erf Oft Kerf). It ( *Hww dk< Aft w of rtft 4^ft for ftf^owi of d* COftdftftMH of po**9<An> Va j a iAo u * to W*4. proK. fttrfft uowKJ be MM *r*tl to b* erf prftCtftl k|M&w*ftt Cirttorf), rf trt*<* a* HtoAftu* ftrt to t* teWurf. fi* %*Ti*ny (fMiMtoN ftW f (Sr f4opbtUwi ft^rto o*t4 b rr^toftrf Ffft (St iifftt erf rfon* toe of 0* ft*. d* b 00 ftBfarotBtaoB rbM t**bk n*ft ft* *u* tftSwMttie Hafti M L_ *ft okn I'm ft ri -r-iM |4gi YMrawM m lift bn i--m* I 4 ft* A lt?tl!*f IV > K^o I I . M h"i M C T**i*ft ft t**r ** *! M>f4. r**4 4* to MW *ift *ft--Op T pn^kftrre of ma K * rtpft* to oat a if** aftft p^Si k* fa coowqurBcyv ftbrthtt o*crt or 1--irtww. t'ftdrr 1 iiy bib Mftrftr* ft* MtftOio* of aw to mk S ytfi**m. oerfft fat (hr ftopoto rf (tftton totft^fto* tototoftf by MfrofOa* * * **** t ham. t*M fn-- ' K * M Ml lft ft* 1lTft*lft ft t**ft f~l f |* ill f | ft J Nft (* * Ih w i ft Ch . M *m t*ww ft c--uftoift . >1; it* *: rM.i m mw m 1 . r"ir^M T l *M Mift It loft CftsA t ^--*7-- f |--r r n 1 i i a * m ft lift Imu ^m 4 ft A A* ft Immarn M* 11 l* * ft * (h* I t*M ft ft . (WM. ). *to LMa ft A Tftiw f (ftM4 t Jto Uwtllli Mft r *-* 1 ~f (on AM* *r. lJo H.| | ft ti; II* ff*( 1 r*4 . IMA A . ftftM t p am4 ftMtft O In * C*>* (** UmAM ti* 1 lift* > A fto M A III.MliiitAilMI In ft *p m T > <** Hwt *4m4 A*tft IW-- ft.* t, lIMft'fo* i t) ftoMft ft* . Cif>t(.. Ar --M1-- 1*11, ft f *Aft 9 I fMMIM* ft lift lWft M--am ft* (** * C*v-- Mift* loMi Yfftr--. IkMH lift ftft* (MB Om i2i m t. *to lift* K A Mm ft I tBAli * Mm IM M--ftihoft. MOM* IMi 4>*4 Ufti M Mcbftftfti **d rrbftW u(<|*rfi awU orf) t* fr|Wrrf a* rath ftftrf irtrfotoMt. I t< (tom t*l l*\ Tft* Mn A*m1 to 0*4fttol b*v f lB A Oft Uft M >* U. am* M--. M Tto to "*--* A<* ft ft* ft**. 1 tv*| 9 . W Itm M 0 |*rf ftto r* to tiMM TM*to ftto f f!A. A ft* A A*ft Ito-- Mtft. ?<* >3* *4 laftn r tft.1 to Oral ftifi ------------1 lev--to*** to l^ftto* * fk*i f *.tfM to (#*ft a Bw m*. P* fim HiMt Nm* to fwfttoftto a to (W 1-- to 4a uii^y "WL.1 yyw "'vkgtsJ-111*1 H GUIDING PRINCIPLES j OF MEDICAL EXAMINATIONS IN INDUSTRY -' r \ IWOwlMbMIW* * mmtm Miiirat AunrhriM >M NA DwWn hM N 355.02 mu ii >;j pill.*' Km \mwu;g *m ."i r" ffgwyay ji^m i *.W ^RHWf LIA10981 Tk* Commit*** iW ikit 14fort fMiulW of: CiAttKt D. Siur, M.D (Ol ), Nh Hmh , Mki UoMM* 1 MO, MMMfHfil Jfcuta P. Ba iu , M D,,-WW*# SulpW Ifvi^v Writ W jonu, M D, Ku mm< !m*m run funo, MD, ChriraU KoBMrr J. Roum, MO, Nw York Cu m R. Kowarrw, M-XX, lww ru 4 * i~---4 **4-4 /wy 7. mi, r* j*. *# rw fiy^yW, ( fM. ky i x IWX I r rf Amv 4 GLIDING PRINCIPLES OP MEDICAL EXAMINATIONS IN 1NDUS1RY /An# Aar* l^yi o}p*ot*d for fS- &!*;* ty ii/ CnuJ ra I*4*n*%sl HroUk. Tk* mala* rial v a fuy/tc* of tkt Cownr%Tt /frivu ratulsd "SftJuol Srtvu4 ia ftftm<aJ*#a" Cu m D. Ramu Arfuif Srcrotory, Thr purpcar of ft health trtvfcft U induMr? te to pro* vide ft pei^am o4 poutrv* health nufitriuaa (or thft etijpL-ryrr*. An onpcMnant elrami of ouch ft program it lb* MprtMMO of iKr health status c4 thr bdmduai through mmauUon, ooun*rl*r* and iinairr m proper job pU*ejjvr*_ Medial tummtioos of ctapkrjeea aw deaifned to permit Mipimml cf wort cnrrpfttihk with the pbruod and mretal fcirxM <4 individual* and to bdp them muDUn thru health. Proper pUmofnt o4 worlrn with due regard (or daft variation* t phvwcal demands mfsmrd by dafferw* jobs, and for thr saint and health bmitaUv* wrvoKrd to dift* abilities, caa mult is knpnnvd job prrfoimuxr, feto fcWmmim, d^rrurd likelihood of injury, Wit (uxvd to thr health and safety o4 others, lessened chance of ag- (Tnbc of diwxdrrv and, doubtlm, ft lortfff produc* trvr ld Eatrranarioo for and assistance n job pUt ement art, therefore, prat Ural, udm*f ;a!urd appfi- cation* of thr (rintipln o4 prmctnt ardrinr. Thr objectives of industrial medical cuainitjow art m foCowt: I. To measure the medical fitness of fedhriduak to perform thru duties without hauud to thnmarKto or othrn. 2 To asikt tndh'idualt k> the jMimrnaocc or heft* prcnetrynl of their health. jwrjwioawi -h v m.* -. ON0- 4 J. To detect the e/TecU of harmful working cood^ lion* and advise cormirv* measure*. 4. To establish a record of live comLikm erf the indi vidual at ti-r tme trf each examination. Medical funuruitot programs, property conducted, provide maximum benefit* to cm(r>lo-,cea, empb^yen. and the ccxT*munty. The nn^^ij should he o<i the pUoamerit erf Individuals arcord.rg to tbetr abll:tir* and not liinjJy r!eclM*n <rf the phvixallT prrfecl and rr/ffLao orf all other*. Vrijuft or questionable exclusion from wk, th/ojfh Improper apj*rf*i>oo erf the hnd-ng* upon ml*' knatioa, it agurat lise puhl welfare and contrary la sound industrial health principle*. Functions of Physicians and Aakii>| hnnmd Maintenance erf (he phevriaD-pslient relationship with fairnrs* lo fc*xh empiovr* and employer it essential to tht Sucre* of any industrial health program. Both dtould led that (heir mwrrxU a/r represented with integrity. The ruminalj o c dvuld he conducted by the phy> ciaa hirntrlf ]t may be facilitated if a nurse or other adequately trained person can doelop bate data (real l)ie examinee, ouch ai hrigta, weight, and ip. Cuana require* that a itunt oe eder female anrodant hr pm> eat when woenrn arr being examined. It h the dut erf the phyucian to interpret medical finding* and to male decmo** regarding thev work sig* nrficance. Health cntrfwriing require* special training and should be performed by the physician or under hit taperviwrn. It it fundamental that the phydeian must have faithand bouletip from personal otarnttion of the \a/iout job* witliin h Ind^ctrr Information showing pbydcal demand*, work inf ronditxru, and accident and health hazards erf each job rUedritioe facilitate* irlfethv placemen*. Scope of the fuaiattio* It is essential (hat each examination be thorough and suitable for it* pirposr. What may be tdecpjats ta on* caae may be quite insufhrimi la another. Many factors influence such decmom. For example, the physical da* I ! r LIA10982 m*w* 1 5 i mand* on aa Ironworker engaged in fominjclion of a i skyscraper arc quite different Incn thus* trf the trdrniary I( might he economically unsound for an (nrntisDf oonhajardtr.it industry to include, r>utir*elv, extensive laboratory and x-ray lent of all a pp? Kants. On h< other hand, a brief and superfw sal rsarnmatton can Le false rrunoary and he misleading to employer and employee aide. The nature erf (he industry, its inherent hazard*. the variation In jobs, aDu physical demands and health ex posures are determinant* The values of different examieusimn procedures and tbor cost in lime and dollars roust be assayed The phrorian, after carefully studying the problems involved, slould achwe management <ootmy iog the scope erf the exartunjiir** to be made. The best tvpe of examination program is sot (hat rmphasin'* flexibility according to need, rather than oe* that has a set and invariable routine. A flexible plan pro vide* foe a basic minimum examination but recognims the difference* between individual*, age group*, and This permits the mmiftug phrsirian to devote Iras time and procedure to the essdmtly >ara!thy yourg bdnidusl hi a nonhaeardou* yob The older wocier engaged is a more haxardoua joh rerrtve* more searching adrotioei, with clinical impmtKjcu gsoned from the history and eiimautym being supplemented bx appropeiat* laboratory lest* Frequency of examinatam should vary with age, wx, ocrupstion, and kndosdual Optaiocts vary considerably M to what ocmstmites a minimum examinatma. The (oOnmnf mimmum has been suggevtcd: hisSory, s#e. height and weight, and general appearance; dun. on, earv Dose, smh and moj'h, deit (lunp and Ik -art , htnph nodes, peripheral blood vessels, abdomen including hrmia, anua, genitalia, and spine and extremities; bl<v>d pressure, puhr, and temperature, urinalrs*s; and visual and hesomg acuity. Ferscmaltfy. temperament, and ugru/icafil nerrout o* mental manifestations should be nosed. la those case* la which an assistant takes the history, (he physician should review h and elaborate the history still further Meat pbrwoam fed that a carefully taken '" - ' LI A10983 persona] health and occupation histort k of great value, M it rruty suggest additional examination or warrant trx attention. T)* trend Ia ixaminatxio* k to make them snort thrxou^h, including chm x-r*v, Laboratory stud***, eW* trwaniingrxrT*, special inr.i^ to the cor/imno site* c4 Catver, u wf II at mental or m*4it>r*A] Kate*. Tl employ** should br examined in pnmy oak should be d**n.ed. TJje men! of the examiaatioa of female jTnjtaia ta A moor point, depending upon whether dir mfttnilii ii (<r employment purport onlf or it part cd a regular health maintenance pUn, upon the Aft of the wOfMn, and upon otfwr factor*. The higher ksev dnxr of tlitiriniul Km brought iKout die more general haciuwoo cd laboratory text* la exammaliae cd persons otn 45 yean od Aft. IWaur cd the importance cd vision with mpect to job Hfxjrofr and afrty, it a advisable to perform rather drtailed vkiro eumiratiom mraiunn^ viauaJ acuity for near and distance, visual held*, color ducnmiftitinw. and depth pfittpUa, tnttruinrnu for m&lisg three too are in general use. DrtaiJrd too and records cd the worker** bearing acuity before rmpiovromt and periodically there* after are odtra cd value. particularly where there it Oft exposure to cwmht aoka. Laboratory too are indopmaable where there la aa txpntute to toxic mhuatti Dm x-ray* before niiphij dent azxi periodically thereafter may be Indicated for wwirn engaged m duty trade*, particularly the mineral Typo* od Fiialoiiio** The various Kindi cd nammatwru may be dialM a* original, periodic, and i|oaL O'lgma* td*u*aJ**xj.--Original exanuaatxou (*ko often called pfrexnploynsmt or preplacemmt exaouno* tioeu) are made for the expert* purpose od determining and recording the phyxkal condition cd the pcoapectri* worker and aa^gnmrnt to a suitable job in which hi* din* ahdittftt if any. wdl not affect hi* prrwrud efficiency, idm, and health nor the aafety cd other*. The applicant (or ha perwmal pbyucian. on the applicant*! approval) a advnrd cd condition* needing attention. T. ^ 1 is* ssn.1 i Ulixynju. , i* tif 7 --Ptncxk examination* ai cm* plo>re may U m i voluntary or required Uot. j If voluntary, it U uejaDy cuiv.irvary tn make the e*j amiiution oti or near the birthday cd each individual. | Thu tieualU results in a reastnahlr spread od ctamina* 4 tioru cner tlr calendar year and eliminate* peak load*. i U the ojer*t.c4 brvol.ed are relatively ooeluiardoua, mtm-ak letween o a u u a iu o can be a* much a* two or three ytirt at tie djc/rtin od iK* piryurian. How* e**r, it b 6rufaiae tl^il pervru pa*t 45 yean od age be examined annually inasmuch a* degrnrratiw disorder* become botuir*)T mar.ifcat around thi* period. A mandatory bask cd periodic examination k uautly *ppl*d to workers who are erposrd to procatq or mato* rials Oat are definite health hazards or whoac work In* xnhr* rcxponahility for tie safety cd other*. Substance* like lead or carbon totncKkridr, capable of causing c* cupjtmal diseaw, are usually subjected to procem COO* tmli to keep tie worken reasonably aafe from poisoning; hi'yyrrsTf, caution dictate* (he a^htaabdrty of penodic medial cxammatkio to be certain that the engineering cootrok are eftretne. This ako enable* early detection of the hv)*rxucrp<jbkr individual and the worker whose personal unsafe practices drfral the control measure*. Frequency ed the examination wiQ vary la accordance with the quality od the erqpnrenag control, (he severity of the exposure and (he sndmdual hading* on each t> aminatinn. Thus, wvnr exposum might justify eumk* tKXU or laboratory test* od die worker* on a monthly Of quarterly bask. >iu j c is other casr* annually or blexmaaSy mas br adrquatr. In a-cnr cawx, scrrcfung Ubncalory trU al regular m> ten ri wJl suffice a* the major portion of a periodic examinatan prvgrxn* with complete rxaminatiooi bring madr lees frequently* Fxaminationa of rxrcuthex may be regarded a* a Spacial t>pr of perwdic examination od a particular class of employee*. VYHde not entirely new, they are becoming more prevalent, and are justified, by their advocates, on the prrrokr that business executive* carry heavy and nexT-ending rvspnm*Mit>ex, Included kt which may b* (he wrlfar* of large number* cd employee*. i-j . .n i- y u pjAtysrw. ;-:g- YVUe nw erf Am proftmcM an on a NfM bake, (MMidoible mota| iccruei wbn they an tehataiy, aided by a thorough promotional campaign Inaamuch aa MMduab toting examination an non weptrain and appreciative <rf tha eervfc*. Practice* vary tegarding me erf m-pUai nodical department* If the io-plant Met leal facility k Haded and equipped to perform any extra *td lwived, eaaay (ad k la preferable is do thoaoa> . tenintiJona eddua tha department. Othetvriar, It la beet o (tad eaacutrm to ovtddc (adlitiea qualdled to per(oam tha required mivice* ((end feeatiaafi'eai.--Spada] caarabiaifoct may fca Indicated at daa orf trader (ram one job to another. The coned erf tnmemitilraHi ifnrava by exatajoaran erf* thoae arfao handle food k aaoch-T example orf facial pnpeaa examination la away Jaikdittioat three an required by late. Many organhadoeu find h eraethtehae to make 'rehaa to irarh* raiaamatlran erf eeaplnyeea who have been abeam more than a pedted awnhra orf daya due to Ih eat oe injury. Tkb k dooe to txaetrol menetaatlrahlc diaeaw w wdl aa to dtmnaiae aukabOity lea return m trail. Upon return to tad Moving andt arfarnre. a acea avahwdoa erf pbytfcal capacatita may be ttareMiy. A*, hahaitjticn paocadaita any be aectawry to wdute daability aad Improve Aa range orf amptoyab&ey. Upon letliiinrai, foalgnadra. or Ontiaatloa of aa ptoymtat. aoena ceganhationa have found it deniable to mde eaamJetatioaa and a ratsrd erf the Cadagi aa that baa. Thk la partiedady true ia epetatioaa iaveleltw drftnile eapoauee to health hawrt~ |{|2q l nj ' Xapolt (etm No angle eiiaiiaitUi report Iona haabeen A eked to adt aO irqubentMe or the taetltai erf detail dtnaed by varioue phytidanipiHn are aeport foem by tha ame. Same report. la cterrem uaa me ao detailed they rw into ecvteai pagto and indede two payee erf mlmne dctnS devoted to perxoael biwory. Tfaeae, k a tneeedrruUe Avergtato erf eplaioa ae toahe actual vniua of web abbenir bhaoey dttal cvea U eoenpletciy hooeet aad i ?**.*/ ' > r : ` 1?^ S'***? mm I KcunM twww ca b obubed far wry qucnk'W Other cxAouAAt&QB forms b u m crc so brief they am b k w valueless m ndequat* itcccdi or m aa the dcufl <4 lb* csjumnariost, Matty physicians prefer that the form Include apace t* maVs aarrati** Doles of any significant history, fadings and tha ndvfea given o the bdMAnl Ouc pnpslar fyp* of fan it that ia whkb the Wv of famine fan nr arranged b a vertical column with four ao tight blank cabanas abngadc. Tbt results of the first wafttftiiioa an tamtil b the fine bUok -rTimei and dated. Subsequent cumination data are tatanj In the adjacent blank enfaara, thereby promoting and fa cSimtbg wapatba with aulict The denied drtad and mranganeat erf (he foem le a awocr (or deeveaoa by the doctor after rnmnhatiea xrkh 'V S'* *. ^ \ 3 fiaaarvaelnei and Ueo erf Kacocdt The re*mining rfrftytirian may properly put tafoema tioa derived (ram laduanial health reeaanetina to tha (ofimriag meat twltr with gxeetrftaaenti al daoetioek Good judg* Mtm ehould be uaed to prevent the taking orf uaBoceemry (can, while tinfhtiiring the haportaaea orf obtaining adequate ptreonal aeeefical ate. S. A tnwacript or pertinent data may be aupptied to another plryeeriea or to beahh agenda, eranqtrfrtd (or Ineuraneo purpcoa on requat or oonietH erfaapioym. S. The employer thmald be ghua a tieatdlretina ( fitnxe to facilitate ydatemeat, A form may be da vited foe thk peyoia 4. The employer Aould be nobbed erf poteaddy hermftd mt wtefmeanent dttoctol Araugh taiaadta. 5. Goecramcatal agenda each at team, eodxom*l erunpreuaiinei crenmieaion*. or beahh authoritia Andd bo aayphtd wkh lorfonaatioa Oil c&dtl order of trben teqtdied by latr. la al other upeta Ao rrafi dratkl chonttM erf S' rl ' 'S'' l- .f*v* > Z*1* . S *&\ 10 hfalO aamlu'`N tocordt ibnU bo rlgUly ebmrvod and term ohould be granted only on written mnoent d tht worker, preferably elver ptelfadaafy docmnon whh the rtemanrnf pbyiiclaa. Suitable Sling equlpentnt and training of ptnonnel should be ptoviclrd fee the nfekoeping and confidential maintenance d ill wMiral raoordt Id the odabi PHtody and contra! of nwvhenl pantmoal ritoan Chnlfirarina Kathode It It Dot tht function of tht pbydeha la Worm tht applicant whether be la to be employed. Tbit It tht ptrafathn and doty cl niuitaaal, at theta aia eehar (acton b addhha la phytical falMni that bear tepee tuttabHity lor employ mint. The irfetnl d completed rrtmhorina teponi ta lay penoca (or use be placement it pantculmfy nederinbia (or vrveral learont. Tbit practice violent the me phywcia-ptt>r reiatiocahip and It aa Inrodna d the cooMryitial nature d ouch ft porta, furthermore. trained Ur penuemd are eatieely unqnalihrd ta lattipeee aaedieal (teat into tenia d walk aignmeaner; tbit it the liqeendiility d the phyrirtat naceiarai lalenaatioa dioald be conveyed by a npn rate In. baaed ea aa agreed plan. Tbit plan or rataif method wiB enable the mwintng phyeirita la convert nwdieal bndmp lata meaaiaffel birl etrial mcmtarlngy. Tbe Uapoft d bdgeuy ward ta dr ntfiling the pbydeal actrritiro and work detaandi d )ebt hat nipydaimrd the ante (aenOiar beat vogue and fadrfnito mrdiral admoaidona. lor example, T|ta work." Many eyrteme d racing are now ta tna. Owe modal deprnda idely upon ctaanficttkai tala three catepfir| lot examples a. Tk tat any work. k fit (or Dyadic Jak c. Rejocdooh Another method mte dw (oHowieg ttanidcatlone: a. rbywcally fit Ice aery work, k Meet that fata (true far week and taatet apfd> earn aUgbh far certain Jobe (the delect may af i*ttjlitSS& jja, rfc II may not be eormetibit bet may require medal nperehfan). c Delect that tequbtt medial attention, fa peeamil) handicapping, and dogutlifioi lor any type al ateplnyiaaM, Soma mrtfedi are weB developed and tavolre a erne- plete apprahal el pbydctl capodda cn a report identical ta lortaae lo tbe tom wed ta analytic Jobe lor tha pbytlcal demandi required of a worker to preform dm jek Tbie method bae many virtura, aa it rwnniim dm edoctirt matching of werktrv to Jobe . -t . Firea dm ptalk and hdintriol health wotdpohlt,dfa edy ban to taetwrflne employment ta nemhatardmm pccupmioen riioold be the foOoerfag fiafiagi: * I, CVemmmkafcla dhetm. It It obvluno that temw ntaable dieeaem nerd to be brought wider prompt cnotrol not only lor tbe bentdt of the tadividud ban lor the public weffare ae wdL Tbia may fa eohe the enmentt d public health odkhk 1 Incapacitating hjury at dormre, One d dm pant eahna ef an examination program It the demrriim of dhren ta In early acagra, when It It meat mm able aa treatment. Appbceiam with taripltm bnt , ** ----ar^-y j c .--<----------------1-- c- | while they mane treatment hem their pmid pbywnana. : taiNur'Ty or <hhem can he referred in tehabStatlmt Ice effective eminence fa Impratltq dmta emyli.jebility and )eh oppotluajiha. 1 Mental Btaeaa ta which bnpalttd Jni%iinnl nr am hew previae cnoprraihe effort. It it sot |enmBy appredamd by hymen that there b a tlpiBtaanl percentateof penooa having mental fltaamertma*, .taooal dmwtmnce. Them ahenstiana can he of i mony drgrvea and liaqeendy can bo Importwl """Cb to act oa oboe to employment. The tiataod, pbnietaa can (tequendy delect three at the that CVMMiAMaMo ,-r .1 * m Bfts lat'A^ir. I* i #