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Re: Comments on article by Koh and Aw

Dear Editor

Quoting both dictionary definitions and statuory requirements, Koh and Aw's education article [1] limits the definition of occupational "health surveillance" to the detection of adverse health effects resulting from occupational exposures. In doing so, they exclude international and national requirements for occupational health and medical surveillance to assess fitness for work.

Looking at the hazard of ionizing radiation, international recommendations,[2] European Directives [3] and UK National Legislation [4] all identify a requirement for surveillance where the primary purpose is an assessment of the individual's fitness for post. Similarly, in considering surveillance of divers, a key element of requirements is an assessment of fitness for work. On a more general level, both in the public and in the occupational setting systems of health surveillance exist for drivers where it is clearly nonsense to suggest that this is aimed at the detection of adverse effects resulting from time behind the wheel. It is therefore suggested that the authors' conclusion needs to be expanded to identify a requirement for periodic examination of individuals, not only to detect reversible ill health, but also to assess fitness for work.

References

(1) Koh D, Aw T-C. Surveillance in occupational health. Occup Environ Med 2003;60:705-710

(2) Recommendations of the International Commission on Radiation Protection publication 60: 1992

(3) Basic safety standards for the health protection of the general public and workers against the dangers of ionising radiation European Union Counsel directive 1996/29/EURATOM 13th May 1996

(4) The Ionising Radiations Regulations 1999 (UK statutory instrument).