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0399 Individual sensitivity. how should occupational health respond? (submitted for the scom day)
  1. Chris Kalman
  1. NHS Forth Valley, Scotland, UK


The requirement for occupational radiation doses to be As Low As Reasonably Achievable (ALARA), promulgated by the International Commission on Radiation Protection in 1977, transformed radiation protection practice. It also led the way to develop similar standards for a range of occupational hazards.

The radiation world is now increasingly recognising the relevance of individual sensitivity to ionising radiations, with the real prospect that this will be incorporated into future occupational protection standards. The key drivers are;

  • a. Known genetic sensitivity, and gene testing is feasible.

  • b. Radiation risk relates to general cancer risk, including lifestyle.

  • c. Some specific risks may be much higher in human subgroups.

Individual sensitivity to other occupational hazards is well established, but little acknowledged. Genetic factors are linked to a wide range of occupational diseases, including those from physical, chemical, biological and even psychological exposures. In relation to lifestyle, there is a synergy between the more than additive effects of radon and asbestos when either is linked with cigarette smoke. We are also aware high occupational risk in subgroups, for example; Type 1 hypersensitivity to Latex being almost exclusively restricted to the strongly atopic.

The ethical, scientific and practical difficulties of standards based on individual sensitivity are huge, with the strong possibility that restricting consideration to radiation induced cancer would not provide a model that is relevant throughout occupational health. It is suggested that ICOH should seek to join with ICRP in setting up a system to look at the issue in its entirety.

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