Introducing Greek Guidelines for the Diagnosis and Treatment of Adverse Health Effects of Occupational Exposure to Metals

Background Aim: Implementing guidelines in the practice of occupational health is a high-priority need, since their use can reduce the variability in practice and increase professional efficiency, resulting in higher quality of health care services. The aim of this report is to provide information regarding the development process of the first series of national guidelines for the diagnosis and treatment of adverse health effects occurring after occupational exposure to hazardous metals in Greece. This task was recently initiated in Greece as part of the health care reform system in the context of the ongoing financial crisis. Methods: The following metals: arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni), which are the most commonly encountered in Greece, were selected to be studied. A systematic review of medical literature resulted in 94 review papers of the initial 3,932 eligible according to the inclusion criteria. Results: For each metal, an extensive report was produced, including physical and chemical properties, routes of exposure, health hazards, medical surveillance, occupational exposure limits, protection and control measures, first aid and rescue, and waste management. Special attention was paid to environmental exposure data, effects on children health, and necessary laboratory examinations. Conclusions: The first series of guidelines, regarding diagnosis and treatment of individuals who have been occupationally exposed to metals is available; it was recently published in Greece by the National School of Public Health, aiming at helping occupational health practitioners enhance the quality of their provided services