Mintz B W
J Occup Med. 1986 Oct;28(10):913-20. doi: 10.1097/00043764-198610000-00005.
This paper will consider medical surveillance in the context of the Occupational Safety and Health Act of 1970. The Occupational Safety and Health Administration (OSHA) has issued (after rule making) health standards covering approximately 24 toxic substances, and all these standards have included medical surveillance programs. OSHA is not only empowered but compelled by law to require medical surveillance programs for exposed employees. At the same time, a number of major legal/policy issues relating to medical surveillance have been raised at the standards rule-making stage and litigated in court. Among the more significant of these are access to medical records, selection of physician, and medical removals. Many of these issues were involved in OSHA's Lead Standard, issued in 1978 and affirmed in relevant part by the Court of Appeals for the District of Columbia in 1980, and in the "medical access" rule, issued in 1980 and upheld by the Court of Appeals for the Fifth Circuit. These two proceedings will be used as a focus for the discussions of medical surveillance programs under the OSHA act.
本文将探讨1970年《职业安全与健康法》背景下的医学监测。职业安全与健康管理局（OSHA）已（在制定规则后）发布了涵盖约24种有毒物质的健康标准，所有这些标准都包含医学监测计划。OSHA不仅有权，而且依法必须要求为接触有害物质的员工制定医学监测计划。与此同时，在标准制定阶段提出了一些与医学监测相关的重大法律/政策问题，并在法庭上进行了诉讼。其中较为重要的问题包括获取医疗记录、医生的选择以及医疗调离。许多此类问题涉及OSHA于1978年发布并于1980年由哥伦比亚特区巡回上诉法院在相关部分予以确认的铅标准，以及1980年发布并由第五巡回上诉法院维持的“医疗准入”规则。这两个程序将作为讨论《职业安全与健康法》下医学监测计划的重点。
