Royce S, Rosenberg J
Hazard Evaluation System and Information Service, California Department of Health Services, Berkeley 94704.
West J Med. 1993 Apr;158(4):372-5.
Occupational lead overexposure remains a major problem. To evaluate the settings in which physicians appropriately prescribe chelation therapy for lead exposure, 7 cases were identified from physician phone calls and mandatory laboratory reporting of elevated blood lead levels to the California Department of Health Services. In the 2 workers with the highest blood lead levels (both of whom had severe symptoms), treatment was indicated. Physicians inappropriately prescribed chelating agents to workers with ongoing lead exposure as prophylaxis against rising blood lead levels and to treat atherosclerotic heart disease. Workers' personal physicians identified lead overexposure in 5 of the 7 cases. Workplace lead medical surveillance programs mandated by the federal Occupational Safety and Health Administration were inadequate in all 5 of the workplaces where information was available.
职业性铅过度暴露仍然是一个主要问题。为评估医生针对铅暴露合理开具螯合疗法的情况，从医生电话记录以及向加利福尼亚州卫生服务部强制报告的血铅水平升高情况中识别出7例病例。在血铅水平最高的2名工人（两人均有严重症状）中，需要进行治疗。医生不恰当地给仍在接触铅的工人开具螯合剂，作为预防血铅水平升高以及治疗动脉粥样硬化性心脏病的措施。7例病例中有5例是工人的私人医生发现铅过度暴露的。在所有可获取信息的5个工作场所中，联邦职业安全与健康管理局规定的工作场所铅医疗监测项目均不完善。
