MEDICAL SCREENING AND BIOLOGICAL MONITORING - A GUIDE TO THE LITERATURE FOR PHYSICIANS

The use of medical screening and biological monitoring has been substa ntial changes in the past two decades specifically in the provision of occupational medical services. For example, national surveys of workp laces conducted by the National Institute for Occupational Safety and Health (NIOSH) showed that the provision of off-site medical care to w orkers increased from 19.6% in 1972-1974 to 57.8% in 1981-1983, althou gh the percent of workers receiving on-site services remained stable d uring the same period. After a recent survey in 1990-1991, the Occupat ional Safety and Health Administration (OSHA) estimated that 6.3% of U S industries have a medical surveillance program at their individual e stablishment. We reviewed NIOSH documents, OSHA's Code of Federal Regu lations, and texts on biological monitoring and medical screening for recommendations on medical surveillance of workers. This report summar izes the medical tests (including biologic monitoring) recommended or used by independent investigators and by the government for OSHA-regul ated substances to provide guidance to physicians and occupational hea lth professionals in accessing the pertinent literature; the utility o f the recommendations is not evaluated.