Carnevale F, Baldasseroni A
UO PISSL G. Pieraccini Azienda Sanitaria di Firenze.
Med Lav. 1998 Mar-Apr;89(2):102-9.
The implementation in our country of recent legislation on carcinogenic risk assessment and management (VIIth title of Law 626/94) is considered. The authors describe potentialities and limits of the new legislation and of the derived Guidelines issued by the Regions. The health policy in this field and possible evolution in the near future are outlined, bearing in mind the experience of other countries. A short list of questions is suggested as a contribution to the discussion on the future scenario: whether exposure to carcinogens should be lower in the working environment than in the general environment; what is the relative importance of multifactoriality, individual biological variability, individual life-style in the genesis of cancers; whether medical health surveillance is worthwhile in terms of primary prevention; is it always true that there is no threshold limit value for carcinogens; what is the role of individual attitudes to prevention in exposure to carcinogens compared to "objective" protection; which balance between costs and benefits should be aimed at.
本文探讨了我国近期关于致癌风险评估与管理的立法(第626/94号法律第七章)的实施情况。作者描述了新立法以及各地区发布的衍生指南的潜力和局限性。结合其他国家的经验,概述了该领域的卫生政策以及近期可能的发展趋势。提出了一份简短的问题清单,以促进对未来情景的讨论:工作环境中的致癌物暴露是否应低于一般环境;多因素性、个体生物变异性、个体生活方式在癌症发生中的相对重要性是什么;就一级预防而言,医疗健康监测是否值得;致癌物是否始终不存在阈限值;与“客观”保护相比,个体预防态度在致癌物暴露中的作用是什么;应追求怎样的成本效益平衡。