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Millions of workers are exposed to hazards in US workplaces, and their health can be protected with aggressive surveillance programs. Table 42–1 lists the number of workers in the United States exposed to hazards for which there is an Occupational Safety and Health Administration (OSHA) standard; many others are exposed to hazards for which no standard yet exists.

Table 42–1.OSHA health standards. Estimates of workers exposed to chemical or physical hazards.

The World Health Organization defines public health surveillance as “the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice. Such surveillance can:

  • serve as an early warning system for impending public health emergencies;

  • document the impact of an intervention, or track progress towards specified goals; and

  • monitor and clarify the epidemiology of health problems, to allow priorities to be set and to inform public health policy and strategies.”

In occupational health specifically, surveillance is the systematic collection and interpretation of both health and exposure data. The goals of occupational safety and health surveillance across all populations include identifying populations at elevated risk of disease or injury as well as estimating the magnitude of those risks; identifying high-risk populations for purposes of resource allocation for prevention; and evaluating the impact of prevention programs. Where risks are not fully characterized, surveillance can also generate hypotheses for further study of the etiology of injuries and illnesses.

Surveillance is either population- or case-based. Case identification is a key component of medical surveillance, which should then be followed by efforts to identify other cases and other individuals at risk, and subsequently to identify the occupational factors that are responsible. Cases can be identified through medical screening, employer reporting of cases such as is required by OSHA in some circumstances, workers’ compensation data, or reporting from medical providers.

Hazard surveillance is an important part of the prevention of ...

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