Abstract
The interpretation of “nearly all workers” as delineated in the preface of the ACGIH booklet, Threshold Limit Values, needs clarification. This paper discusses the possible meaning of “nearly all workers” and proposes that while it is reasonable to protect all workers at the lower end of the frequency-response plot in a homogeneous population, it is not feasible to protect small “idiosyncratic” populations. The protection of various groups of workers is discussed: 1) workers with genetically determined idiosyncracy, e.g., G6PD to TNT; 2) workers sensitized to a contaminant, e.g., TDI; 3) workers with a disease predisposing them to the effects of contaminants, e.g., coronary heart disease and carbon monoxide, methylene chloride or nitroglycerine; 4) workers with habits which predispose them to extra risk, e.g., alcohol drinking and dithiocarbamates, smoking and asbestos; and 5) workers whose sex or reproductive status exposes them to extra risk, e.g., pregnant women and lead. It is proposed that the protection of such workers is a legitimate goal of pre-employment placement medical examinations. De Silva, P. TLVs to protect “nearly all workers.” Appl. Ind. Hyg. 1:49–53; 1986.
