Stayner L, Kuempel E, Rice F, Prince M, Althouse R
Education and Information Division, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA.
Am J Ind Med. 1996 Apr;29(4):353-7. doi: 10.1002/(SICI)1097-0274(199604)29:4<353::AID-AJIM14>3.0.CO;2-0.
The regulation of hazards is one of the most dramatic forms of intervention in occupational safety and health (OSH). Despite their high degree of potential social and economic impact, relatively little research has been conducted to specifically evaluate the effectiveness of OSH standards with regard to preventing occupational diseases and injuries. This paper reviews the basic scientific approaches that may be used to evaluate the efficacy of OSH standards. These approaches encompass the following research areas: (1) exposure surveillance, (2) disease surveillance, and (3) prospective studies following the introduction of the standard. Research on asbestos and asbestosis, respirable crystalline silica (quartz) and silicosis, and respirable coal mine dust and coal workers' pneumoconiosis (CWP) are used to illustrate these approaches and the type of information that is currently available. The examples (quartz, coal dust, asbestos) reveal substantial limitations in the types of information currently available for evaluating the efficacy of these OSH standards. Ideally, plans for evaluating the efficacy of OSH standards should be developed for existing and future standards. These plans should include programs for the surveillance of exposures and adverse health effects and, when possible, for prospective studies designed to evaluate how the risk of disease (or injury) is modified by the introduction of the standard.
对危害因素进行管控是职业安全与健康（OSH）领域中最具影响力的干预形式之一。尽管职业安全与健康标准具有高度的潜在社会和经济影响，但针对其在预防职业病和工伤方面的有效性进行专门评估的研究却相对较少。本文回顾了可用于评估职业安全与健康标准效力的基本科学方法。这些方法涵盖以下研究领域：（1）接触监测；（2）疾病监测；（3）标准实施后的前瞻性研究。本文通过对石棉与石棉沉滞症、可吸入结晶硅石（石英）与矽肺、以及可吸入煤矿粉尘与煤工尘肺（CWP）的研究，来说明这些方法以及目前可获取的信息类型。这些例子（石英、煤尘、石棉）揭示了目前可用于评估这些职业安全与健康标准效力的信息类型存在重大局限性。理想情况下，应针对现有和未来的标准制定职业安全与健康标准效力评估计划。这些计划应包括接触监测和不良健康影响监测项目，并在可能的情况下，开展前瞻性研究，以评估标准的引入如何改变疾病（或伤害）风险。
