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Medical Surveillance in Museums & Galleries

Medical Surveillance in Museums & Galleries. Katherine Duvall, MD, MPH, MS Co Director, Health in the Arts Program University of Illinois at Chicago. What is Medical Surveillance?. Systematic collection and analysis of data to detect early signs of work-related illness

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Medical Surveillance in Museums & Galleries

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  1. Medical Surveillance in Museums & Galleries Katherine Duvall, MD, MPH, MS Co Director, Health in the Arts Program University of Illinois at Chicago

  2. What is Medical Surveillance? • Systematic collection and analysis of data to detect early signs of work-related illness • Can be considered as a type of medical screening • Is backup to industrial hygiene exposure assessment

  3. Why Do Medical Surveillance? • The purpose is to identify work related disease at an early stage • Early detection may result in more successful treatment • Can identify risk factors for disease/injury • May detect non-work related disease • Health promotion

  4. When is a Medical Surveillance Program Needed? • When exposures exceed the action level • If new materials or processes are introduced and leading to concern of worker safety

  5. What is Involved in Medical Surveillance? • History • Physical exam • Testing • Analysis of results • Communication of results • Maintain records

  6. What are the Steps in Medical Surveillance? • Needs assessment • Selecting target population • Selecting tests • Interpretation of tests • Intervention if needed • communication

  7. Needs Assessment • Potential for exposure • Review toxicity of materials • Guidelines: OSHA, ACGIH, NIOSH • Is medical surveillance needed • Frequency of testing

  8. Target Population • Who is potentially exposed? • Based on current employees

  9. Test Selection • Lab test—blood, urine • Chest x-rays • Lung function testing • Hearing tests

  10. Interpretation of Tests • Must have protocol for results • Refer to primary physician? • Remove from exposure? • False positives • False negatives

  11. Intervention • Does employee need to be removed from exposure? • Does process/materials need to be changed? • Environmental controls? • Personal protection equipment?

  12. Communication • Inform employee of results in writing • Inform supervisor of restrictions if needed

  13. Biological Monitoring • Test biological specimen (blood, urine, etc.) for presence of toxin • Assess exposure to toxin • Does not necessarily mean disease • Half life important in terms of when to collect

  14. Biological Monitoring (continued) • Can evaluate multiple exposures • Measures what is most directly related to potential health effects

  15. Lead • Can be present in paint and glazes, stained glass • Can affect central nervous system, kidneys, peripheral nerves, blood, reproduction • OSHA Lead Standard • History, physical exam • Blood lead and ZPP • Level over 40ug/100ml means significant overexposure • Remove worker if level is > 60ug

  16. Mercury • Used as pesticide, pigment or preservative • Can cause central nervous system, behavioral and renal effects • History, physical exam • Urine testing

  17. Arsenic • Can be used as pesticide • Affects skin, liver, nervous system • Is a risk factor for lung cancer • History and physical exam • Urine test (can be affected by seafood consumption)

  18. Solvents • Used to clean and thin paints • Can affect skin, liver, blood (benzene), peripheral and central nervous systems • History and physical exam • Urine for metabolites • Carbon monoxide in exhaled air, or carboxyhemoglobin in blood for methylene chloride

  19. Asbestos • Used in plaster, fire retardants, taxidermy • Can can pulmonary fibrosis • Can result in lung cancer • OSHA Asbestos Standard: • Annual exam and termination exam • History, physical • Pulmonary function study • Periodic chest x-ray

  20. Summary • OSHA general duty clause: workplace must not have recognized hazards likely to cause death or serious physical harm to employees • Medical surveillance can help protect the employee by early recognition of injury/illness • Through biological monitoring, can also assess potential exposures

  21. Summary (continued) • Medical surveillance protocol should include: • Purpose of medical surveillance and any particular focus on an organ system • Type of examination, history items • Schedule of surveillance • Types of tests to obtain • Acceptable levels for test • How employee to be notified • Intervention and action to be taken • Follow up studies • Record keeping

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