Toxicology forum (18-22 June, 1990 Budapest, Hungary).
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Biomedical subjects
Publications and source records attributed to J A Indulski.
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This work reviews the legal regulations constituting the basis for control of chemical substances present in the working and natural environment as well as in food and utility products in Poland. It has been found that there are many regulations which comply with legislative needs. However, a lack of general regulation on the protection of human health and the environment against the noxious effects of chemicals is widely acknowledged. The unsatisfactory condition of human health and environment in Poland may be attributed to the fact that the existing standards are often disregarded. The authors are of the opinion that implementation of an organizational and legal system of chemical safety would be an important step towards improving the existing situation.
In highly developed countries the prophylactic medical examinations to evaluate health effects of exposure and general health condition of the workers started early in the past. Nowadays, there is an increasing trend of developing new methods for early detection of occupational and work--related diseases. Thus the individuals oversensitive to the agents of the working environment could be prevented from exposure. However, the gap between the capacities that the new methods offer theoretically and their actual application in the prophylactic examinations still remains quite large. Part I of the present study has been devoted to three essential problems of public concern which have been specified in the paper's subtitles.
This work focuses on main aspects of a proposed system of chemical safety in Poland. General principles have been formulated, including theoretical guidelines, definitions and functions. Additionally, organizational and legislative structures have been proposed. A basic principal of the system says that each activity related to the application of chemical compounds creates a risk of adverse health and environmental effects. According to the definition adopted, chemical safety means such levels of chemical compounds in the environment, coming from various sources, which ensure that the risk of adverse health effects and other negative effects will not surpass socially acceptable levels. The chemical safety system is aimed at preventing and limiting the risk of undesirable health and environmental effects from chemical compounds. It is proposed that the system be coordinated by the National Coordinating Committee on Chemical Safety. The most urgent task of the Committee would be to draft a law on human health protection against the harmful effects of chemical compounds.
A number of current issues regarding methods of primary and periodical medical examinations were discussed in view of application of research results in practical activities of the occupational health service. The review of tests employed on detection of deficiency or peculiarity of biochemical susceptibility to given chemical factors revealed objective causes limiting and delaying, to a certain extent, of practical application of scientific progress in health surveillance. Tests facilitating detection of susceptibility to emphysemagenic factors, genetic markers of atherosclerosis, neoplasm (especially neoplasm of the urinary bladder and lung cancer) were discussed. According to the opinions presented, further advancement of research, as well as application of new methods should, during a relatively short time, dispel existing doubts and accomplish standardization of methods. The usefulness of psychological tests, now being introduced to health surveillance, was also discussed. It was found that tests may enrich considerably certification of physical fitness for those jobs with high stress levels and requiring a high level of reliability. They are extremely useful in individual assessment of work load, and they allow the detection of early disorders in the central and peripheral nervous system, preceding evident pathology produced by working environment factors. The most common obstacles in the wide application of the discussed methods include: inadequate post-graduate education of psychologists; the rare combination of two specialisations (psychology of labour and clinical psychology); and a shortage of test methods which have been verified in the conditions of a given country. This work also raises questions about the health effects of exposure to electromagnetic radiation, complex exposure to toxic substances, health condition and periodical examinations in workers of advanced age.
The paper discusses principles of the chemical safety system to be introduced in Poland. It is thought that the system should be based on a doctrine comprising theoretical considerations, definitions of concepts and scope of activity. Moreover, the organizational and legal background of the future system was also considered. According to the main principle of the chemical safety system, any activity, involving the use of chemicals gives rise to a risk of adverse health and environmental effects. The numerical value that can be assigned to such risk ranges between 0 and 1. Thus an essential activity related to chemical safety seems to be the determination of a socially acceptable risk. Chemical safety has been defined as an environmental state where the chemical substances of different origin pose either no risk of adverse health and environmental effects or the risk whose level is socially acceptable. The chemical safety system aims at limiting or preventing the risk arising from the use of chemicals. It is suggested that the activities of the future system should be supervised by the National Coordinating Committee for Chemical Safety which would stimulate both the research work on risk assessment and management as well as other activities pertaining to chemical safety.
Presented in the paper are opinions on night work. The authors submit not only their own views but also those of other researchers. The material points to considerable hazards of the night work, including specific negative health effects. However, it could hardly be defined who is more harmed by the night shift--women or men, except for its probable contribution to reproduction disturbances in women. Genetic effects are not clear--they call for further studies. Apart from the negative effects of the night shift upon health, family and social life, the paper deals with the issues of minimising those adverse effects, including some examples of preventive measures.
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The aim of the present paper is to inform Polish occupational physicians about a new medical discipline called immunotoxicology which developed during last decades. The importance of immunotoxicology resides in the fact that examinations performed on its basis make it possible to understand some toxic mechanisms which could not have been explained so far studying biochemical disorders. Immunotoxicology is regarded as an extension of toxicology. According to the principles of immunology, organism's reactions to xenobiotics action depends on the mechanisms regulating immunological system, i.e. on its activity or suppression. Considering the present scientific achievements, it can be said that both these states are related to disregulation of homeostatic mechanisms. Owing to the informative nature of this paper, many examples of immunological reactions were adopted from the relatively rich world literature. Readers who are interested in more comprehensive information may refer to source literature.
The genesis of the vast problem--of cognitive and applicatory nature--referred to as chemical safety, has been presented. Chemical safety studies involve all possible sources of man's exposure to chemical compounds, which is aimed at an effective control of adverse health effects. The authors have set up a definition according to which chemical safety occurs where exposure to chemical compounds coming from various sources causes a specific health risk not higher than the socially accepted level. The contribution of Poland to the International Program of Chemical Safety (IPCS) should promote the exchange of experiences and access to scientific and technological information.
Main components of the problem of chemical safety, their role and aims as well as their mutual relations are presented. Need to create a register of chemical compounds and necessity to set up an information centre which would help functioning the whole system are justified. Risk assessment is believed to be the main aspect of cognitive activities aimed at determining the probability of occurrence of harmful consequences of exposure. Risk assessment is a set of complex legal, organizational and administrative undertakings supposed to reduce the hazards resulting from exposure to chemicals. Necessity to calculate costs and benefits coming from the undertaking and need to analyse social perception of risk which is important for preventive action are justified. What is stressed is the significance of a widespread education aimed at forming attitudes towards chemical hazards.
Changes in the system of research planning and co-ordination in Poland promoted the development of centrally supervised programs with preferences in financial terms. Of 100 centrally supervised programs, four are related to medical sciences, in this one--to occupational health. The research program, accepted after a profound discussion, has been mainly directed towards: progress in reliable evaluations of work environment in national economy; establishment of interrelationships between work conditions and workers' health in many industrial branches; and development and enforcement of effective preventive measures. Priority is given to the following research trends, the results of which may significantly affect the efficiency of health- and preventive care rendered to workers: development and control of new methods for early diagnosis of health lesions prior to clinical pathology and prior to the occurrence of work disablement, whether temporary or durable; development and enforcement of methods allowing to single out workers susceptible to the effects of particular environmental hazards with the aim of avoiding unforeseeable health effects of occupational exposure. determination and verification of conditions promoting the effectiveness of the primary health care for workers covered by the industrial health service. development and verification, under model conditions, of the principles of organizing and functioning of the primary health care, especially preventive care, for workers of small plants which hitherto have not been covered by the industrial health service. development of a more effective--than the hitherto functioning--system of rehabilitation for disabled people, especially occupational rehabilitation being accomplished at special workplaces. A detailed list of goals planned to be achieved up till 1990 has been attached to the complete version of the paper.