Schecter A
Environ Health Perspect. 1985 May;60:333-8. doi: 10.1289/ehp.8560333.
The panel discussion from the perspective of occupational medicine regarding appropriate medical surveillance after a PCB transformer or capacitor incident is reviewed. A thorough occupational medicine history and physical examination is stressed for any worker or other patient who may have been exposed. Appropriate laboratory tests, including complete blood count with differential, serum chemistries, serial blood PCB determinations, fat biopsy to estimate furan and dioxin levels, if indicated, pulmonary function tests, chest X-rays, urinalysis including porphyrin measurement, nerve conduction velocity testing and other tests are discussed. No consensus was reached on recommended length of medical followup. Because the field is rapidly changing, yearly updates of medical protocols are warranted. In addition, the need for surveillance to be conducted by specialists with training and experience in the fields of occupational medicine and nursing was emphasized. It was stressed that measuring the chemicals and their levels in soot and air and then comparing these with the patient's blood or fat levels, in the case of PCBs, furans and dioxins, is vital. It was noted that at present no modality of treatment is known to be clinically efficacious in removing PCBs, furans and dioxins from tissues or blood.
本文回顾了职业医学领域关于多氯联苯（PCB）变压器或电容器事故后适当医学监测的小组讨论。对于任何可能接触过的工人或其他患者，强调要进行全面的职业医学病史采集和体格检查。讨论了适当的实验室检查，包括血常规及分类、血清化学检查、连续血液多氯联苯测定、必要时进行脂肪活检以估计呋喃和二噁英水平、肺功能测试、胸部X光检查、包括卟啉测量的尿液分析、神经传导速度测试及其他检查。对于推荐的医学随访时长未达成共识。由于该领域变化迅速，医学方案需要每年更新。此外，强调需要由在职业医学和护理领域接受过培训且有经验的专家进行监测。有人强调，对于多氯联苯、呋喃和二噁英，测量烟尘和空气中的化学物质及其水平，然后将这些与患者的血液或脂肪水平进行比较至关重要。有人指出，目前尚无已知的临床有效治疗方法可从组织或血液中清除多氯联苯、呋喃和二噁英。
