Stijkel A, van Dijk F J
Utrecht University, Department of Science, Technology, and Society, The Netherlands.
Occup Environ Med. 1995 May;52(5):294-303. doi: 10.1136/oem.52.5.294.
Internationally, the debate on aims for occupational health policy is expanding its horizons. Included among the issues are not only concerns about safety for workers, but also for their progeny. Equality among the sexes is also assuming a prominent position. In several countries, existing and proposed legislation already considers these matters. In the course of this article it is argued that this legislation and its implementation are inadequate. There are several reasons for this. Firstly, what constitutes health risks for workers exposed to chemical substances is subject to different interpretations. This is further complicated when one includes risks to reproductive function and to the progeny: the reproductive risks of toxicity. The different interpretations of the concepts of safety and equality are also discussed. There are differences in regulations and in standards about whether or not safety factors should be used when knowledge is uncertain. The operation of reasonable measures with a generic or sex specific policy also differs. Secondly, the current occupational exposure limits are set too high. These aspects are considered and it is probable that the policy aims should be made more specific. An elaborated approach that includes the "precautionary principle" in safety standards is proposed. To advise employers in their role as managers of reproductive risks of toxicity, a recently developed system for occupational health and safety services is described. This system is based on two criteria: effectiveness and reasonableness of proposed measures. The effectiveness criterion includes the precautionary principle; the reasonableness criterion includes equal rights and opportunities for men and women. Finally, a supportive governmental policy that is consistent with the most recent international development is recommended.
在国际上，关于职业健康政策目标的辩论正在拓展其视野。这些问题不仅包括对工人安全的关注，还包括对其后代的关注。性别平等也占据了突出地位。在几个国家，现行和提议的立法已经考虑到了这些问题。在本文中，有人认为这种立法及其实施是不够的。原因有几个。首先，对于接触化学物质的工人而言，什么构成健康风险存在不同的解释。当将对生殖功能和后代的风险（即毒性的生殖风险）包括在内时，情况会更加复杂。还讨论了对安全和平等概念的不同解释。关于在知识不确定时是否应使用安全系数，法规和标准存在差异。通用政策或针对性别的政策中合理措施的运作也有所不同。其次，当前的职业接触限值设定得过高。对这些方面进行了考虑，政策目标可能应该更加具体。提出了一种在安全标准中纳入“预防原则”的详尽方法。为了指导雇主履行其作为毒性生殖风险管理者的职责，描述了一种最近开发的职业健康与安全服务系统。该系统基于两个标准：提议措施的有效性和合理性。有效性标准包括预防原则；合理性标准包括男女平等的权利和机会。最后，建议制定一项与最新国际发展相一致的支持性政府政策。
