special subjects
Overview of Occupational and Environmental Medicine
Worker Screening and Surveillance
OEM physicians provide medical screening and surveillance of workers in workplaces with potential exposures to hazardous substances. In the US, the Occupational Safety and Health Administration (OSHA) issues medical screening and surveillance standards for general industry and for states and individual companies; a number of substances are included (see OSHA:Medical Screening and Surveillance). Medical screeningis done to detect disease or dysfunction before a person would normally seek medical care. For example, people who may be at high risk of certain conditions are screened (eg, periodic cholesterol testing or A1C testing). Medical surveillanceinvolves periodic evaluations of one or more workers over time to look for workplace hazards that require targeted prevention measures (eg, periodic blood lead levels in workers who might be exposed to lead). Surveillance usually relies on screening results from a group of workers being evaluated to look for abnormal health trends. Depending on the substance involved, either screening, surveillance, or both may be indicated. 