U.O. di Medicina del Lavoro Az. Spedali Civili di Brescia,Sezione di Medicina del lavoro e Igiene Industriale, Università di Brescia.
Med Lav. 2012 May-Jun;103(3):187-97.
The purpose of this review is to suggest job fitness criteria for health care workers exposed to sensitizing or chemical agents. These recommendations are derived from a comparison between previous documents on prevention and management of allergic and chemical risks in health care settings and updated evidence; the job fitness criteria and the main documents on these topics are summarized in tables. Glove allergy, in particular latex allergy, is still a significant problem but we should remember that a wide choice of alternative materials is now easily available; many different alternative health products are also currently available when an allergy to disinfectants or detergents is diagnosed. Hence the prevention of allergic diseases is mostly based on an appropriate choice and use of the gloves and health products according to the specific tasks and possible individual susceptibility; this meets the requirements of the "good health care organization", which translates into lower costs, if possible, as well as the best protection of worker's health. Concerning chemical risk, it should be remembered that during the last 20 years the improvements made in work environments have profoundly changed the mode and the levels of exposure to chemical substances and the current recommendations concerning the management of workers exposed to anesthetic gases, antineoplastic agents and sterilizers/disinfectants significantly differ from those of early 1990s. However, the past prudential guidelines are still valid for formaldehyde.
本次综述的目的在于为接触致敏剂或化学制剂的医护人员提出工作适应性标准。这些建议源自先前有关预防和管理医护环境中过敏和化学风险的文件，并结合了最新证据进行了对比；工作适应性标准和相关主题的主要文件均以表格形式进行了总结。手套过敏，尤其是乳胶过敏，仍然是一个重大问题，但我们应记住，目前有大量的替代材料可供选择；如果诊断出对消毒剂或清洁剂过敏，目前也有许多不同的替代医疗产品。因此，预防过敏疾病主要基于根据具体任务和可能的个体敏感性，适当选择和使用手套和医疗产品；这符合“良好医疗组织”的要求，不仅降低了成本（如果可能），还能更好地保护工人的健康。关于化学风险，应记住，在过去 20 年中，工作环境的改善极大地改变了接触化学物质的方式和水平，目前有关接触麻醉气体、抗肿瘤药物和消毒剂/清洁剂的工人管理的建议与 20 世纪 90 年代初的建议有很大不同。然而，过去的谨慎指南对于甲醛仍然有效。
