The strategy of targetted health surveillance. II. Genetically determined susceptibility to chemical substances and other issues related to health surveillance.

A number of current issues regarding methods of primary and periodical medical examinations were discussed in view of application of research results in practical activities of the occupational health service. The review of tests employed on detection of deficiency or peculiarity of biochemical susceptibility to given chemical factors revealed objective causes limiting and delaying, to a certain extent, of practical application of scientific progress in health surveillance. Tests facilitating detection of susceptibility to emphysemagenic factors, genetic markers of atherosclerosis, neoplasm (especially neoplasm of the urinary bladder and lung cancer) were discussed. According to the opinions presented, further advancement of research, as well as application of new methods should, during a relatively short time, dispel existing doubts and accomplish standardization of methods. The usefulness of psychological tests, now being introduced to health surveillance, was also discussed. It was found that tests may enrich considerably certification of physical fitness for those jobs with high stress levels and requiring a high level of reliability. They are extremely useful in individual assessment of work load, and they allow the detection of early disorders in the central and peripheral nervous system, preceding evident pathology produced by working environment factors. The most common obstacles in the wide application of the discussed methods include: inadequate post-graduate education of psychologists; the rare combination of two specialisations (psychology of labour and clinical psychology); and a shortage of test methods which have been verified in the conditions of a given country. This work also raises questions about the health effects of exposure to electromagnetic radiation, complex exposure to toxic substances, health condition and periodical examinations in workers of advanced age.