Table 1 Overview of routine medical examinations
From: Targeted medical examinations for workers exposed to fumigants
Fumigant | Routine medical examination |
|---|---|
Methyl Bromide | ● Medical history evaluating for past medical conditions or symptoms involving the following systems. ○ Neurological ○ Respiratory ○ Skin ○ Liver ○ Renal ● Examination ○ Skin - looking for evidence of contact dermatitis, frostbite, or burns ○ Vision (i.e. visual acuity and direct fundoscopy) - looking for signs of optic atrophy ○ Neurological (i.e., gait, peripheral and cerebellar) - looking for neurological features of chronic exposure such as impaired gait, loss of coordination, muscle weakness and peripheral neuropathy) |
Hydrogen Phosphide | ● Medical history evaluating for past medical conditions or symptoms involving the following systems. ○ Respiratory ○ Haematological – looking for signs, symptoms and complications of anaemia ○ Oral maxillofacial - (i.e. history of soft tissue swelling, jaw pain, dental problems and gum discharge) - looking for evidence of mandibular necrosis ● Smoking history ● Examination ○ Respiratory – looking for evidence of bronchitis and respiratory irritation ○ Neurological examination (i.e., focusing on cranial nerve V, central and peripheral nervous system) - looking for evidence of motor and speech deficits ● Specific Diagnostic Tests ○ FBC ○ Spirometry (baseline) |
Hydrogen Cyanide | ● Medical history evaluating for past medical history and symptoms involving the following system ○ Thyroid ○ Vision ○ Neurological ○ Respiratory ● Examination ○ Neurological examination (i.e. central and peripheral nerve examination) - looking for non-specific neurological effects such as tremors, weakness and sensory deficit, ○ Visual examination (i.e., focusing on visual acuity, cover and uncover test and direct fundoscopy) - looking for features of optic atrophy and amblyopia ○ Thyroid examination (i.e., goitre) - looking for evidence of thyroid dysfunction ● Specific Diagnostic Tests ○ Thyroid Function Tests ○ Urine Thiocyanate Levels |
Sulfuryl Fluoride | ● Medical History evaluating for past medical history and symptoms involving the following system ○ Neurological symptoms looking for muscle twitching, tingling, numbness or weakness; ○ Gastrointestinal symptoms such as abdominal pain, diarrhoea or constipation; ○ Musculoskeletal symptoms such as pain, muscle weakness, deformity or reduction in range of movement; ○ Dental symptoms such as pain or mottling of teeth ○ Respiratory symptoms such as shortness of breath, cough and reduced exercise tolerance ○ History of past and current alcohol consumption ● Examination ○ Neurological (i.e. gait, central and peripheral nervous system) – looking for weakness, muscle twitchiness, numbness ○ Musculoskeletal system - looking for deformity or stiffness ○ Abdominal system - looking for signs of liver disease such as jaundice or hepatomegaly ○ Dental evaluation - looking for signs of fluorosis which are mainly chalky appearance, cloudy white lines, brown or yellow discolouration of teeth ○ Respiratory system - looking for signs of pneumonitis. ● Specific Diagnostic Tests ○ Renal Panel ○ Liver Function Tests ○ Urinary Fluoride Level |