Medical screening and biomedical monitoring violate individual rights. Such conflicts of right with right are acted upon synergistically by uncertainty which, in some important respects, increases rather than decreases as a result of research. Issues of rightness and wrongness, ethical issues, arise because the human beings who are subjects of medical screening and biological monitoring often have little or no option whether to be subjected to them. We identify issues of rightness and wrongness of biomedical surveillance for various purposes of occupational health and safety. We distinguish between social validity and scientific validity. We observe that principles are well established for scientific validity, but not for social validity. We support guidelines as a way forward.
The measurement of radon flux from soil surface is the useful tool for the assessment of radon-prone areas and monitoring of radon releases from uranium mining and milling residues. The accumulation chambers with hollow headspace and chambers with activated charcoal are the most used devices for these purposes. Systematic errors of the measurements strongly depend on the geometry of the chamber and diffusion coefficient of the radon in soil. The calibration system for the attestation of devices for radon flux measurements was constructed. The calibration measurements of accumulation chambers and chambers with activated charcoal were conducted. The good agreement between the results of 2D modelling of radon flux and measurements results was observed. It was demonstrated that reliable measurements of radon flux can be obtained by chambers with activated charcoal (equivalent volume ~75 l) or by accumulation chambers with hollow headspace of ~7-10 l and volume/surface ratio (height) of >15 cm.
Clinical and morphological features of cancer were observed in two groups of miners (of Krivoy Rog iron-ore and Zholty Vody uranium mines), working in hazardous labour conditions. In both of groups the disease course had typical features for lung cancer. Roentgenologic changes were observed, central cancer of left and right lung was revealed by bronchoscopy method. In all the cases lung cancer was morphologically proved and classified as squamous. Rapid progression of the disease and late medical aid appealability cause the patients consulted with their doctors only at the stage of II-III, sometimes III of the disease and it makes a distinction of lung cancer in miners of iron-ore and uranium mines. In order to prevent such a late diagnostics all the miners should be referred to the group of risk on lung cancer.
Exposure to the radioactive daughters of radon is associated with increased risk of lung cancer in mining populations. An investigation of incidence of lung cancer following a clinical survey of Ontario uranium miners was undertaken to explore whether risk associated with radon is modified by factors including smoking, radiographic silicosis, clinical symptoms, the results of lung function testing, and the temporal pattern of radon exposure.
Miners were examined in 1974 by a respiratory questionnaire, tests of lung function, and chest radiography. A random selection of 733 (75%) of the original 973 participants was followed up by linkage to the Ontario Mortality and Cancer Registries.
Incidence of lung cancer was increased threefold. Risk of lung cancer among miners who had stopped smoking was half that of men who continued to smoke. There was no interaction between smoking and radon exposure. Men with lung function test results consistent with airways obstruction had an increased risk of lung cancer, even after adjustment for cigarette smoking. There was no association between radiographic silicosis and risk of lung cancer. Lung cancer was associated with exposures to radon daughters accumulated in a time window four to 14 years before diagnosis, but there was little association with exposures incurred earlier than 14 years before diagnosis. Among the men diagnosed with lung cancer, the mean and median dose rates were 2.6 working level months (WLM) a year and 1.8 WLM/year in the four to 14 year exposure window.
Risk of lung cancer associated with radon is modified by dose and time from exposure. Risk can be substantially decreased by stopping smoking.
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'McIntyre Powder' (finely ground aluminium and aluminium oxide) was used as a prophylactic agent against silicotic lung disease between 1944 and 1979 in mines in northern Ontario. To find out whether the practice produced neurotoxic effects a morbidity prevalence study was conducted between 1988 and 1989. There were no significant differences between exposed and non-exposed miners in reported diagnoses of neurological disorder; however, exposed miners performed less well than did unexposed workers on cognitive state examinations; also, the proportion of men with scores in the impaired range was greater in the exposed than non-exposed group. Likelihood of scores in the impaired range increased with duration of exposure. The findings are consistent with putative neurotoxicity of chronic aluminium exposure.
This paper reviews the epidemiology of lung cancer in uranium miners in northern Ontario whose cumulative exposure was relatively low and who were exposed only for a short period of time. The development of the "epidemic" is demonstrated chronologically and in terms of latency. An apparent difference between the effects of short-term and of more prolonged radiation is shown. A dose-response effect is demonstrated at all levels. Analysis of tumor type suggests that there may be a difference in dose-response between the two principal types encountered. The relationship of the geographic location of exposure to the final residence at death is reviewed.