Chemistry Reference
In-Depth Information
CHAPTER
16
Principles for Prevention of the
Toxic Effects of Metals
PHILIP J. LANDRIGAN, DAVID KOTELCHUCK, AND PHILIPPE GRANDJEAN
ABSTRACT
on health, including effects on early development.
Reduction of exposure
may involve outright bans of cer-
tain uses of toxic metals—the most effective strategy;
reduction of workplace or environmental concentra-
tions using the technologies of industrial hygiene and
environmental control; and use of personal protective
equipment—the least effective strategy.
Monitoring
may involve monitoring of the workplace or general
environment or biological monitoring and health ex-
aminations of exposed populations.
Training
involves
education of managers, workers, health professionals,
policy makers, and the general public about the health
risks posed by toxic metals and approaches for risk re-
duction. To be effective, all of these programs must be
supported by
authority
, which usually is based in law.
Great success has been achieved in reducing toxic
effects of metals in occupational and nonoccupational
populations, but much work still remains to be done.
Precaution should guide all decisions on whether
to permit further dissemination of metals into the
environment.
Prevention of the toxic effects of metals begins with
identifi cation of the populations at risk of exposure. In-
dustrial workers, long the principal focus of concern,
remain the group at greatest risk. Nonoccupational
populations—young children and pregnant women in
particular—are also at risk today through exposures in
air, food, water, and consumer products. These nonoc-
cupational exposures are the result of wide environ-
mental dissemination of metals in the past century and
affect millions of persons. Toxic effects in occupational
and nonoccupational populations may be clinically ev-
ident or subclinical. Toxic effects may occur in women
and children at levels below those that cause effects in
workers.
The tools available for prevention of toxic effects
include exposure assessment, environmental monitor-
ing, biological monitoring, medical monitoring, and a
range of public health interventions. Medical exami-
nations may sometimes be of use and can pinpoint
reasons for increased susceptibility that may require
additional action. Preventive interventions should
seek ways to target the source of the problem and may
require action to remove a subject from a dangerous
exposure. Treatment may be necessary as a last resort,
when prevention fails.
Five principles guide the prevention of toxic ef-
fects: (1)
hazard identifi cation
; (2)
reduction of exposure
;
(3)
monitoring
; (4)
training
; and (5)
authority. Hazard
identifi cation
includes recognition of the sources and
routes of exposure and explanation of the range effects
1 INTRODUCTION
The unique properties of metals—their durability,
stability, and resistance to chemical breakdown—are
simultaneously the basis for the wide and constantly
expanding range of industrial applications of metals
but also are the basis for the extensive distribution and
persistence of metals in the environment and for the
hazards they pose to human health.
