Role of medical surveillance in risk management.

Abstract

Occupational physicians face increasing pressure by health authorities, employers, and employees to provide practical, targeted, and meaningful medical surveillance to workers handling nanoparticles. On the basis of experience and literature review, examples were identified for successful medical surveillance activities. Consideration was given to the respective context in which they provide benefit, and whether these examples may be extrapolated to the present situation with nanoparticles. Occupational medical surveillance based on existing knowledge of hazards and potentially associated health effects is both feasible and useful. In the absence of sufficient knowledge, results from surveillance programs may still provide new insights into exposure-response relationships or help to identify new hazards. In some situations, however, medical surveillance may also produce harm. Medical surveillance provides benefits on the individual, company, and societal level, provided that it is planned and performed with its limitations in mind.