[Reference values in occupational and environmental medicine].

Abstract

Origin, significance, production and use of reference values (RV) in environmental and occupational medicine are discussed. The concept of RV was established in last sixties to correctly interpret data from modern clinical chemistry, but its acceptance in occupational medicine was neither immediate nor easy. These difficulties were mainly due to the nature and biological fate of analytes for which RV were requested, quite different from those of clinical chemistry. For this reason specific procedures to select the subjects, to control the pre analytical factors and to set up analytical methods are necessary. The Italian Society of Reference Values (SIVR) attempted to achieve concepts and practice for RVs and proposed RVs produced by specific investigations for some metals and organic compounds. Furthermore in this paper two provisional lists of RVs for metals and organic substances are proposed. Finally the relationship between RVs and other more familiar guide line values such as action levels and limit values is discussed.