BASIC PRINCIPLES IN OCCUPATIONAL HYGIENE 职业卫生基本原则 Day 2 第 2 天

8 - BIOLOGICAL MONITORING AND HEALTH SURVEILLANCE 8- 生物监测及健康监护

BIOLOGICAL MONITORING AND HEALTH SURVEILLANCE 生物监测及健康监护 What experience do you have? 有什么类似的经验吗？

BIOLOGICAL MONITORING AND HEALTH SURVEILLANCE 生物监测及健康监护 Health Surveillance is a generic term: any procedure undertaken to assess, review or monitor an individual’s health in order to identify or detect any significant change from normality. 健康监护是通用术语：是评估、审核和监测个人健康所采取的任何程序，其目的 是为了检测人体是否出现了任何异常变化。 There are three reasons for health surveillance at work: 进行职业健康监护的三大理由如下： –to ensure adverse health effects related to the work are identified at an early stage; sometimes this is statutory, e.g. in relation to work with lead. – 为了确保能在早期就能发现工作对健康造成的不良影响；有时，健康监护 是强制性规定，例如对于与铅接触的工作。 –to ensure continued medical fitness for specific tasks like diving or fire fighting – 为了确保具有执行特定任务所需的良好健康状况，如潜水或消防等。 –to promote general health. – 为了促进身体健康。

BIOLOGICAL MONITORING AND HEALTH SURVEILLANCE 生物监测及健康监护 Health surveillance techniques should be: 健康监护技术应符合如下条件： Highly sensitive 灵敏度高。 Specific in their ability to detect effects at an early and reversible stage. 具备能在早期和可逆阶段发现负面作用的能力。 Safe. 安全性高。 Preferably non-invasive and acceptable to the employee. 最好是非侵入式，员工可接受。 Cost is also a consideration. 成本也是一个考虑因素。 Results of health surveillance should lead to some action of benefit to the health of employees. 应能通过健康监护结果，制定有利于员工的措施。

BIOLOGICAL MONITORING (1) 生物监测 （ 1 ） Biological monitoring is an integral part of health surveillance and is the measurement of human tissues, fluids or behaviour in comparison with what is considered to be a normal range of values. 生物监测是健康监护不可分割的一部分，是对人体组织、体 液或行为进行测量，并将测量结果与正常值进行对比的程序。 –Medical confidentiality applies. – 应符合医疗保密规定。 –Can establish not only exposure but also its effect on an individual or group of people. – 不仅可以确定接触限值，还能确定对个人或群体的影 响。

BIOLOGICAL MONITORING (2) 生物监测 （ 2 ） Biological measurements can determine:- 生物测量可以确定： –the content of a toxic material or its metabolite in blood, urine and breath – 血液、尿液和呼气中有毒物质或代谢物的含量。 –Its effects on enzyme systems or metabolic pathways – 对酶系统或代谢途径的影响。 –Early reversible tissue change – 早期可逆转的组织变化。 –Physiological changes Immunological changes. – 生理变化、免疫系统变化。

Types of Measurements 测量类型 Urine 尿液 –Cells (exfoliate cytology) - bladder cancer – 细胞（尿液细胞学诊断） - 膀胱癌 –Level of toxin e.g. mercury – 毒素含量，如汞 –Level of metabolite eg TCA (tricarboxylic acid) – 代谢产物含量，如 TCA （三羧酸） –Protein (especially kidney damage) – 蛋白质（尤其是肾脏损害） –Bile (jaundice) – 胆汁（黄疸） –Sugar (diabetes) - relevant to shift work, public service vehicle (PSV) driving – 糖（糖尿病） —— 与轮班、公共服务车辆（ PSV ）驾驶相关

Types of Measurements 测量类型 Blood 血液 –Full blood count and haemoglobin - lead, benzene, alcohol, work in the tropics – 全血计数和血红蛋白 —— 铅、苯、酒精、热带地区工作 –Serum (deep frozen) - baseline antibody levels in pathogen exposure – 血清（深度冷冻） —— 病原体接触的基准抗体水平 –Liver function tests - alcohol, hepatotoxic chemicals – 肝功能检查 —— 酒精、肝毒性 –Renal function tests - kidney toxins – 肾功能检查 - 肾脏毒素 –Toxin levels - e.g. lead – 毒素含量 - 例如铅 –Metabolite levels - e.g. ALA. – 代谢水平 - 例如 ALA 。

Types of Measurements 测量类型 Skin 皮肤 –Appearance – 外观 –Prick testing – 皮刺试验 Breath 呼吸 –Dichloromethane and carbon monoxide exposure. – 二氯甲烷和一氧化碳接触限值。 Vision 视力 –Acuity tests e.g. lorry drivers, pilots etc. – 视力测试，例如货车司机，飞行员等。 –Colour blindness tests e.g. civil aviation, railways, microscopy. – 色盲测试，例如民航、铁路、显微镜学行业。

Types of Measurements 测量类型 X-rays X- 射线 –Chest x-rays are useful for conditions such as infection – 胸部 X 光检查可用于检测感染等情况。 –Pneumoconiosis chest x-rays – 尘肺病胸部 X 光检查 Neurological tests 神经系统测试 –Mental function 心理功能 –Nerve transmission – 神经传递 –Handwriting tests (detects early tremors) – 手写测试（检测早期震颤） Audiometry 听力测试 –The lowest intensity of hearing – 最低强度听力测试 Lung function tests 肺功能检查 –Lung volume – 肺容积 –Airways resistance. – 气道阻力