Analysis of race effects on drug-test results.

Substance abuse has become one of the most pressing public health problems of our times. Its impact on the US workforce is staggering, both in terms of lost productivity and the cost of providing medical care to its victims. Employers usually have programs in place to reduce the impact of substance abuse, which include testing prospective and/or current employees' body fluids or tissues for recreational drugs. Although urine testing remains the test of choice among most employers, the use of hair as a testing matrix has increased substantially in recent years. There has been a legal concern that there may be racial bias in hair testing. In studies of human populations, there has been limited investigation of this issue. This study investigates this question by evaluating the hair-test results of a large cohort of applicants for employment with a major metropolitan police department. The results of the study failed to show any racial bias and thereby suggest that hair-testing methodology would not create a disparity among applicants.

Clinical experiences: development of a medical surveillance protocol for hazardous waste workers.

Medical surveillance of hazardous waste workers is essential for the health of these workers, who have unique, complex exposures. In order for this preventive tool to be effective, the supervising and/or examining physician must be educated about the specific health risks of hazardous waste workers and also must perform a comprehensive examination. Results of testing should be evaluated both for remarkable abnormalities as well as longitudinal subtle changes in individuals, and also for trends in workers with similar exposures. Fitness for duty determinations should be then made with appropriate communication of abnormalities and follow-up recommendations to both employers and employees. To date, clinical and research findings from clinical centers performing surveillance examinations on hazardous waste workers have not revealed remarkable abnormalities related to their potential exposures. The possible causes for these results include: (1) the workers have been well protected; (2) the current diagnostic methodologies are not sensitive enough to detect pathophysiologic changes; and (3) disease may not yet be manifest due to latency or cumulative effects of long-term low-dose exposure. In addition, one must keep in mind that previous clinical and research data were collected from test results of workers who were mainly involved in feasibility, as opposed to remediation, activities. With the prospective change of more clean-up involvement of hazardous waste workers, their potential for exposure may increase. Therefore, periodic collaborative evaluation of existing surveillance programs' results (e.g., every 5 years) is advised. This would allow determination of the efficacy of the current diagnostic methods in detecting disease, as well as the possible inclusion of more sensitive and/or specific newer technologies for use on a more routine basis.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluating physical fitness for hazardous waste work.

The lifting of heavy loads is the most physically demanding aspect of many occupations. Clean-up work at hazardous waste sites involves heavy manual labor, frequently under significant thermal stress created by personal protective equipment. Worker fitness is particularly important in hazardous waste work in view of the increased demands required on the musculoskeletal and cardiopulmonary systems.