[Examination medicine in the industrial health--aspects of biological monitoring].
The data of the health examinations for workers during the last few decades show two changes on the health level of labor. One is the reincrease of the prevalence rate of the detected diseases in the periodic health examinations (PHE) after once decrease, the other is the continuous decrease of the prevalence rate of the clinical findings owing to harmful work in the special health examinations (SHE). The first change requires us to consider the PHE as not only the mass screening method of the adult diseases but also the health-check to collect the information provided for the preparation and the evaluation of the health instruction by which the worker tries to promote his own health. The second change suggests that the SHE for the workers employed for harmful work should not be regarded hereafter as the screening method for the occupational diseases but as the biological monitoring for the exposure and the effect of the low level of the harmful compounds to workers. In the case of lead workers, for instance, the lead concentration in blood (B-Pb) and in urine (U-Pb) and the delta-amino levulinic acid in urine (U-ALA) are employed in SHE as the biological monitoring, and these have been considered to correlate well with the lead level in the air (A-Pb). However, A-Pb in workshops B-Pb, U-Pb and U-ALA level in the lead workers are decreasing year by year.(ABSTRACT TRUNCATED AT 250 WORDS)