Szeinuk J, Beckett W S, Clark N, Hailoo W L
Division of Environmental and Occupational Medicine, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
Am J Ind Med. 2000 Jan;37(1):142-57. doi: 10.1002/(sici)1097-0274(200001)37:1<142::aid-ajim11>3.0.co;2-k.
The purpose of a respirator is to prevent the inhalation of harmful airborne substances or to provide a source of respirable air when breathing in oxygen-deficient atmospheres. For a physician to recommend the use of respirator, general background information on respiratory-protective devices is required. The first part of this clinical practice review describes the general aspects of industrial hygiene, respirators and a respirator-certification program. The second part addresses matters related to medical certification for respirator use. Medical certification for respirators is an important part of the activities of the occupational physician. To determine whether a worker is able to tolerate the added strain of a respiratory protective device is a complex process in which factors such as fitness for work, health of the individual, characteristics of the work itself, and the properties, type, and requirements of the respiratory protective device, have to be considered. Medical certification is of utmost importance for respirator use, and it should be viewed as an element in a comprehensive respiratory protection program. A comprehensive program is the key element in affording the workers' effective respiratory protection once the initial steps of the hierarchy of methods of hazard control have proved insufficient or infeasible. As a result, the need for the industrial hygiene/safety officer, the worker, the employer and the medical professional to work as a team is much more than in any other field of occupational medicine--a necessary requirement for making the right decision.
呼吸器的目的是防止吸入有害空气传播物质，或在缺氧环境中呼吸时提供可呼吸空气的来源。医生若要推荐使用呼吸器，需要了解呼吸防护设备的一般背景信息。本临床实践综述的第一部分介绍了工业卫生、呼吸器和呼吸器认证计划的一般情况。第二部分讨论与呼吸器使用的医学认证相关的问题。呼吸器的医学认证是职业医生工作的重要组成部分。确定一名工人是否能够耐受呼吸防护设备增加的负担是一个复杂的过程，其中必须考虑诸如工作适应性、个人健康状况、工作本身的特点以及呼吸防护设备的性能、类型和要求等因素。医学认证对于呼吸器的使用至关重要，应将其视为全面呼吸防护计划的一个要素。一旦危害控制方法层级的初始步骤被证明不足或不可行，全面的计划就是为工人提供有效呼吸防护的关键要素。因此，工业卫生/安全官员、工人、雇主和医学专业人员作为一个团队开展工作的必要性比职业医学的任何其他领域都要大得多——这是做出正确决策的必要条件。
