Medical surveillance for hazardous waste workers

The efforts to clean up hazardous waste disposal sites have led to an increasing number of workers involved in these activities. Industrial hygiene surveys have demonstrated that these workers are potentially exposed to low levels of multiple contaminants during the work day and to high levels of some contaminants for very short time periods. Personal protective equipment and work practices are important components in protecting workers from these exposures. Medical monitoring for these workers is problematic. While monitoring for the potential health effects of these multiple exposures may be useful, any attempt to monitor for possible health effects of all potential exposures could lead to a long array of medical tests. The utility and effectiveness of this approach is doubtful. Screening for a worker's physical ability to conduct hazardous waste cleanup jobs while he wearing protective equipment is also important and may cause difficulties due to our limited knowledge in this area. These issues will be discussed in the context of various programs designed to monitor these workers.