Health surveillance protocol

Members of staff who will visit or work in a POP’s polluted site should undergo specific medical protocols with special attention to symptoms related to hazardous substances exposure. These checkups should be done before starting the works in order to ensure no staff members hold any medical incompatibility and to verify no effect arose during work by comparison to post-work blood tests. Furthermore, checkups are necessary periodically and as soon as overexposure to hazardous substances has occurred. The following table recommended medical checkups.

Download table: Recommendations for medical checks (PDF 27 KB)

The specific medical checkups that have to be performed will depend on the length of stay and the type of contact with contaminants.

  • Site visits with no direct contact. Medical checkups should be performed before visiting the contaminated area and afterwards, including mainly a spirometry test and a blood analysis.

  • Stays with no direct contact. Medical checkups should be performed before visiting the contaminated area and afterwards, including a spirometry test, blood analysis and manual load handling tests at the beginning. Once works have finished additionally analysis of POP’s in blood should be performed.

  • Stays with direct contact. Medical checkups should be performed before visiting the contaminated site, afterwards and during works. Initially no biological control is necessary. For this reason, before visiting the site a complete medical check-up will be performed, excluding just analysis of POP’s in blood. On the other hand, during on site stays, only a regular biological control will be necessary and after finishing with works a complete check-up should be performed without Chest X-ray.

It is also important to take into account medical incompatibilities that will limit the access of workers who present any of them. These incompatibilities may include:

  • Asthma, atopy, bronchial hyperreactivity or respiratory patology that causes respiratory failure typified as grade 1 or higher (cough, dyspnea and/or slight sibilance), FVC, VEMS or both under 85%.

  • Antecedents or dermic hypersensivity or pruritus syndrome generalized or not controlled (kidney failure, hyperthyroidism, diabetes, nipothyroidism, lymphoma, leukemia, multiple myeloma, drug susceptibility, scabies, pediculosis, ascariasis, polycythemia Vera, iron shortage, paraproteinemia, intrahepatic cholestasis, etc.).

  • Pregnant women or in breastfeeding period.

  • Those whose blood tests present less than 4000000 red blood cells/mm3, less than 5000 white blood cells/mm3, less than 50% of neutrophils, a number of platelets less than 100000/mm3 or coagulation alterations.

  • To suffer from neurological pathology that causes cephalea, nausea, paresthesias, myclonus, antecedents of convulsion or “status epilepticus” or other neurovegetative alterations.

  • Medicine consumption: sympathomimetic, carbamazepine, Chloranphenicol, cytotoxics, gold salts, Mephenytoin, Phenylbutazone, phenytoin, sulphamides, Trimethadione, Zidovudine, adriamicine, antiarrithmics, atropine, antichlorinesterase, Beta blockers, digital drugs, lithium, phenotiazide, thyroid hormone, tricyclic antidepressant, verapamil.

  • Hematological alterations: suffer or have suffered from myeloproliferative syndromes (acute myeloid leukemia, erithroleukemia, myelofibrosis, chronic or acute myelomonocytic leukemia, acute lymphoblastic leukemia) or lymphomas.

  • High frequency heart failure and arrhythmias or preexcitation syndromes.

  • Hepatic failure and unchaining diseases.

  • Proteinuria and kidney.

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