RT Book, Section A1 Fischman, Michael L. A1 Rugo, Hope S. A2 LaDou, Joseph A2 Harrison, Robert J. SR Print(0) ID 1104102634 T1 Occupational Hematology T2 CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 5e YR 2013 FD 2013 PB McGraw-Hill Education PP New York, NY SN 9780071808156 LK accessmedicine.mhmedical.com/content.aspx?aid=1104102634 RD 2024/04/19 AB Occupationally related hematologic toxicity has occurred in a somewhat cyclical fashion, historically associated with the introduction of some new and untested chemicals into commerce. A common factor contributing to “epidemics” of toxicity has been the exposure of large numbers of workers without adequate protection. As the toxicities of these agents gradually became known, regulation of their use was instituted and exposure was reduced. Because hematologic toxicity, like other noncancer health effects, is known to exhibit a threshold for induction, subsequent reduction in exposure levels led to reduction in the frequency of these illnesses. In some cases, exposure to certain toxins such as radium has been eliminated. Hematologic toxins, such as lead, benzene, arsenic, and arsine gas, are still used; poisonings leading to hematotoxicity occasionally still occur in the workplace, and, in some settings, worker or consumer education is inadequate. The study of hematotoxicity has improved our understanding of hematologic pathophysiology, taught important pharmacologic lessons, and introduced the concept of individual susceptibility to specific toxic agents. Observation of individual variations in susceptibility to toxic agents was made by recognizing that chemicals with oxidative potential could cause cyanosis and a life-threatening hemolytic anemia in some individuals at exposure levels that had little effect on the population at large. The normal population will manifest similar toxicities but only when exposed to much higher levels. Consequently, it is important to identify workers with increased susceptibility to certain chemicals and place them in jobs with less risk of contact with these specific toxic substances, although elimination or reduction of exposure for all workers is a preferable strategy.