Abstract

The findings of special medical examinations are not infrequently summarized in the form of health classification. This procedure seems valuable for the protection of workers'health from personal health as well as public health point of view, because health classification of workers provides occupations health workers with birds eye view informations in terms of medical, placement and educational procedures, which are to be followed after medical examinations. In this study, the authors have reviewed the existing systems of special medical examinations and Health classifications in different countries and those recommended by international organizations for the purpose of improving the current system in Korea. The important issues covered in this review in relation to health classification of workers included the categories of diseases, the examination and laboratory tests, the criteria for health level classification and the health instructions to be given at each health levels. It was found that the current health classification system in Korea could be featurea as follows : 1. Special medical examinations are always carried out in combination with general medical examinations, contributing to the detection of risk factors of occupational diseases. 2. The selection of examinees is always made on the basis of work environment monitoring, often resulting in the underdetection of exposed workers. 3. Even if the test items are properly selected according to the principles of occupational medicine, further review is required in the light of recent advances in the pathogenesis as well as early changes of occupational diseases and epidemiologic principles. 4. The criteria for the classfication of health levels are to be reviewed on the basis of clinical epidemiology. 5. The health instructions covered only medical and placement aspects, failing to introduce the concept of health promotion.