Schilling R S
J Occup Med. 1986 Aug;28(8):553-7. doi: 10.1097/00043764-198608000-00005.
Work-related disease is the product of multiple factors, including host susceptibility, the external environment, and individual behavior. The concept of multiple causality is relevant to the etiology of diseases, in which work and exposures are contributory agents, and of diseases that have a single necessary cause, eg, lead poisoning. The objectives of medical screening in the control of work-related diseases are the subjects of this paper. Screening procedures include questionnaires, diagnostic tests, function measurements, and biological tests of exposure levels to environmental agents. Achieving the objectives of medical examinations depends on selecting appropriate tests that are acceptable to workers; discarding tests that cannot meet requirements with respect to reproducibility, specificity, and sensitivity; and periodically reviewing health surveillance programs as a whole, and modifying or abandoning them as necessary in the light of improved working conditions.
职业病是多种因素的产物，包括宿主易感性、外部环境和个人行为。多因果关系的概念与疾病的病因相关，其中工作和接触是致病因素，对于有单一必要病因的疾病，如铅中毒也是如此。本文探讨了控制职业病时医学筛查的目标。筛查程序包括问卷调查、诊断测试、功能测量以及环境因素接触水平的生物学测试。实现医学检查的目标取决于选择工人可接受的合适测试；摒弃在可重复性、特异性和敏感性方面不符合要求的测试；定期对整个健康监测计划进行审查，并根据工作条件的改善情况，必要时对其进行修改或摒弃。
