Foà V, Ferioli A
Istituto di Medicina del Lavoro, Università degli Studi, Milano.
Med Lav. 1990 Jan-Feb;81(1):11-21.
Improvement in environmental conditions in industry is producing a progressive reduction in the dose of absorbed substances. This has repercussions on the work of the occupational health physician, who now has to face a new set of problems, problems which at the same time offer occasions for further research in risk assessment of chemical agents. The most obvious finding, which has perhaps been handled more systematically, concerns the change in occupational diseases, whence the need to extend designs and protocols of health surveillance. The expected effects of occupational exposure to low doses of a chemical fall within the category of what may be defined as long-term effects, carcinogenic effects and, above all, effects involving systems or apparatuses that are sensitive to low doses but over long periods, such as, for example, the immune and the reproductive systems. This new situation than has repercussions on biological monitoring: in the first place on the problem of setting reference values and on the study and control of confounding factors; secondly, on the predictivity of the biological indicators used. In some cases, in fact, the indicators of dose that the occupational health physician has learnt to use and on which his approach to prevention his based, proved to be no longer predictive in such new exposure situations.
工业环境条件的改善正在使吸收物质的剂量逐步降低。这对职业健康医生的工作产生了影响，他们现在不得不面对一系列新问题，这些问题同时也为化学制剂风险评估的进一步研究提供了契机。最明显的发现（或许已得到更系统的处理）涉及职业病的变化，因此有必要扩展健康监测的设计和方案。职业接触低剂量化学物质的预期影响属于可定义为长期影响、致癌影响的范畴，最重要的是涉及对低剂量但长期敏感的系统或器官的影响，例如免疫和生殖系统。这种新情况对生物监测产生了影响：首先是关于设定参考值以及研究和控制混杂因素的问题；其次是关于所使用生物指标的预测性问题。事实上，在某些情况下，职业健康医生已学会使用并以此为预防依据的剂量指标，在这种新的接触情况下已不再具有预测性。
