記：2013年3月12日
http://www.socialstyrelsen.se/sosfs/1991-6/andringdforeskrift1998-3にあった内容
2013年3月のログ
スウェーデン保健庁のサイトにあった勧告。
この勧告は本文にも明記されているがスウェーデンの電磁波過敏症などの研究者であるカロリンスカ研究所のOlle
Johanssonも、スウェーデンの電磁波過敏症に関する市民団体であるthe Association
for Electrical and Display Damaged (FEB)も参加して、作成されていることは注目に値する。
＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊
Constitutional
Amendment（法改正） SOSFS 1998:3
National Board guidelines on treatment of patients relate their problems to
amalgam and electricity Recommendation
アマルガムと電磁波の問題に関する患者の取り扱いに関するスウェーデン保健庁ガイドライン （勧告）
This is a change in the Constitution of the internet version. It is also
available in print. It is the printed publication to.
To see the entire revised constitution with all amendments introduced, go to
the "View basic constitution and amendment provisions" (below) and
the "Latest version" of the page that follows.
Introduction
Patients put their
complaints in connection with amalgam fillings or electromagnetic fields often
feel that they get a bad attitude in health care. They do not think they will
be taken seriously, they do not feel respected and understands that many in
health care believe that their symptoms are imaginary or purely psychological
in origin. A problem in the investigation of these patients is that there is no
scientific evidence proving one correlation between overall disease symptoms
and amalgam fillings and electricity. On the other hand, a connection can not be excluded for some patients. However, there are no clinically
evaluated sample can specify which of these patients would then be. Welfare has
the expert reports stated that the patients need to be carefully investigated,
and otherwise make a careful handling. In 2 a § Health Act (1982:763) states
that care should be based on respect for patient autonomy and integrity and as
far as possible be designed and implemented in consultation with the patient.
With regard to the complaints made by patients and patient associations, the
Board considered it indicate certainty that, as a support for health care, the
general guidelines elaborate on how to respond to and investigate these
concerned patients. In working with the general guidelines have participated a working
and a reference. In both groups, the Medical Officer of Health Per Swartling
been president and agency director Eva Thoor secretary, both active in the
National Board of Health and the medical team. The working group has concluded
the following members: Sven-Olof Andersson, MD, Mariehems clinic, Umeå, Bridget
Evengård, MD, Infectious Diseases , Huddinge Hospital, Lena Hillert, Senior
Assistant, Centre for environmental impact, Community Medicine South, Huddinge,
Olle
Johansson, Associate Professor, Department of Experimental Dermatology,
Department of Neuroscience, Karolinska Institute, Sven Langworth, MD, Occupational
Medicine Department, Huddinge Hospital, 'Magnus Svartengren , Associate
Professor and MD, Occupational Medicine Division, Department of Public Health
Sciences, Karolinska Hospital The reference has concluded the following
members: Einar Berg, International Academy of Oral Medicine and Toxicology,
Sweden (IAOMT-Sweden) Birgitta Berglund, National Society for ME patients
Agneta Ekman Swedish Dental Association Sten-Olof Grönqvist, Dental Injury
Association Jan Håkansson, Riksförsäkringsverket Margareta Karlsson, the
Swedish Rheumatism Association January Kullberg, the Association for Electrical and Display Damaged (FEB) Ingvar Noren, Swedish Medical
Association
Background
Purpose
The general guidelines
have been developed to provide guidance to health workers in contact with patients relating their
problems to amalgam fillings or electricity. Some patients have a
definite opinion that the tooth replacement materials, mainly amalgam, and
electricity is the cause of their symptoms and wish physician involvement to
amalgam or elsanering. Here is a conflict, then
the doctor has no scientific basis to meet the patient's wishes. These include of these difficulties
in patient-physician relationship as the general advice is. The general advice
is aimed primarily at physicians, especially in primary care. Even dentists are
concerned with regard to problems related to amalgam fillings. They shall, however,
refer to a doctor for assessment of general symptoms of the patient. Finally,
the general advice interest for current patients and their compounds, Dental
Injury Association and the Association of Electricity and Screen Damaged. The
guidelines contain no new review of the scientific literature dealing with the
effect on health of amalgam and electricity.
Knowledge
State
National Board in
November 1994 issued expert reports "Making You Sick of amalgam?"
(SoS report 1994:21) and in January 1995, "Electromagnetic fields and
health effects" (SoS report 1995:1). Both reports concluded that it was impossible to
scientifically either confirm or reject a causal link between dental amalgam
and electricity and the problems or illnesses experienced by patients. The exception was contact allergic
changes in the oral mucosa of amalgam. Welfare has after expert reports were
released continuously monitored the scientific literature on the health effects
of dental amalgam and electricity. government has found it to indicate
certainty that a deeper understanding is reached on the possible health effects
of mercury from amalgam has. Against this background, the Government in spring
1997 to Forskningsrådsnämnden to carry out activities in order to create
overview and in-depth knowledge in the field. Reporting to the Government shall
take place on 1 February 1998. , in June 1997, a report from a working group of
the European Commission with recommendations to the Commission regarding dental
amalgam. The report shows that there is not shown any link between mercury from
amalgam fillings and general toxic effects in the body. According to the
report, there is no reason to remove functioning amalgam fillings except in
cases with proven allergy to mercury. It is also recommended that all filling materials
should be evaluated to the same extent. The report has not yet been accepted by
the European Commission. Council for Work Life Research in 1997 on behalf of
the government put together a research and evaluation of both Swedish and
international research on health effects of electromagnetic fields.
The
authorities' precautionary principle
Despite the uncertain
state of scientific knowledge regarding possible connections between elpåverkan
and various diseases or appeal, a number of agencies expressed a common
assessment of the publication "The authorities' precautionary principle of
low frequency electric and magnetic fields, a guide for policy makers"
(1996). Relevant authorities are the National Board, the National Electrical
Safety Board, the National Board and Institute of Radiation Protection. The
assessment states that there are reasons for some caution in terms of exposure
to low frequency electric and magnetic fields. Authorities recommend that one
should strive for a reduced exposure using measures that can be taken at
reasonable cost. The assessment is not specifically about people who put their
complaints in connection with electricity.
General
recommendations on the use of amalgam
Welfare recommends as in
previous general counsel to mercury and its compounds should be handled so that
both individual exposure and contamination of the surrounding environment
minimizes the level. Although there is no evidence amalgamfyllningars
harmfulness, the use of amalgam gradually decrease with regard to the general
environmental aspects. Previous recommendations to avoid amalgam work on
pregnant women still apply.
Scientifically
proven
When a causal
relationship on a particular issue can not be shown scientifically, it means
obviously not to any suspicion of such a connection can be excluded. It is
important to always be open to new knowledge. It is, however, considerable
demands on the studies presented to a causal relationship to be considered
proven in a scientific manner. It is not enough that a number of patients were
reported to have been improved after amalgam or elsanering. The selection of
patients must be properly and treated group must be compared with a control
group. The number of patients must be large enough to exclude random variation.
Regarding treatment effects of amalgam, respectively elsanering positive
results reported in some studies, while other studies have not confirmed this.
Some scientifically clear conclusions have not yet been established.
CREDIBILITY
GAP
A credibility gap has
emerged between the patients and the health service. Many patients who have a
belief about the cause of their problems have been experienced that the doctor
has taken a totally dismissive attitude to the patient's own interpretation of the
background to the symptoms and sometimes even experienced physician questioned
symptoms. Patients with amalgam and electricity-related disorders often feel
not captured on seriously. Symptoms can also create fear of the unknown, it is
difficult to explain. Patients report that many physicians and dentists
consider them sick imagination, referring to the National Board reports that no
connection is shown. By repeating statements from these patients shows that
they experienced themselves casually treated. They have often chosen to seek
out health care providers who have themselves been convinced of a connection
and helped amalgam or elsanering. , it gives cause for reflection when groups
of patients in severe criticism of the care and the National Board of Health,
which is perceived to give a false picture of scientific certainty. It is
incumbent upon all of the licensed health care professionals to act on science
and proven experience. As in many reports of individual cases reported
favorable results of amalgam, respectively elsanering regarding patients'
symptoms, it was indicate the location of the National Board, with the help of
expert groups examine the causal relationship has been demonstrated in
controlled trials. Such a relationship could not be demonstrated. Patients have
sometimes felt that they were not considered to be ill and therefore would not
be healthy or simulated. This mistaken view has obviously offended and upset
many patients. In both expert reports highlight that patients' symptoms are real
and that patients naturally be shown respect. The multifaceted problems
requires a careful and comprehensive investigation so that the diseases and
conditions that may contribute to the symptoms are recognized and treated.
Responding
Consultations
When a doctor is
consulted by a patient to relate their problems to amalgam or electricity, he
is often faced with a difficult task. Some physicians perceived（と判る） as
nonchalant（むとんちゃく・無関心な） or dismissive（拒否するような） may have been frustrated for
patients with conditions that they could not meet. They have not succeeded in
creating a good relationship with patients. Doctors should not lock itself when
the patient or her own opinion about the cause of the symptoms, but have a
responsibility to the patient is comprehensively investigated. At the same
time, the physician must respect the patient's own opinion. How the doctor
succeed in this balance determines probably the continued contact can be
trustful. Patients should be convinced that the doctor has the same objective
as the patient, namely to relieve the patient from discomfort, regardless of
what they are caused by. If patients find that the doctor involved and is eager
to help his patient, are certainly far better opportunities to discuss various
alternative approaches, regardless of the cause of the symptoms. Each patient
needs to physician listens and takes the patient's symptoms seriously, symptoms
that the patient would be confirmed and understood. GPs are generally best
suited for the investigation of patients with amalgam or electricity-related
disorders. They have a broad training and experience in investigating patients
with diffuse and general symptoms. The general practitioner is also able to
utilize other personnel such as a nurse, physiotherapist, occupational
therapist, social worker and psychologist.
Symptoms
In reports on groups of
patients with amalgam-and electricity-related disorders reported a variety of
symptoms. No symptoms are specific to a particular disease, but occurs in a
variety of diseases and functional disorders. Certain general symptoms occur
frequently in both groups of patients. There are fatigue, weakness, achiness in
the body, difficulty concentrating, loss of memory, dizziness and headache.
These symptoms are common even in the general population.
Patient
Contact
Good knowledge and good
contact with the patient is a prerequisite for the doctor to discuss it, for
most people familiar interplay between physical and mental problems. A bodily
disease can cause such anxiety and depression. Conversely, stress and anxiety（不安） give bodily pains
such as palpitations, headache, diarrhea and fatigue. It is not uncommon for
patients with serious physical illnesses while having symptoms of a
psychological nature which ignored can complicate treatment and worsen
prognosis. Though the social situation affects disease progression and
symptoms. It is therefore important to have illuminated relationships in family
and work, past traumatic life events etc.. If the trusting plug missing, there
are usually not placed to address these important issues. Questions of this
kind can be of some patients perceived as irrelevant, unnecessary, disruptive
and insulting. They must be made with great feeling and sensitivity to the
patient's reactions. All questions are suitable not to discuss at the first
contact. , it is important to explain to the patient the importance of being
able to see the patient's entire life in order to understand the role that
disease plays. That said, the social and professional situation would explain
the patient's symptoms. The disease can often affect the social situation,
which in turn may exacerbate disease symptoms. The doctor can help the patient
to reflect on this and get a starting point for further discussion on what
patients can do to improve their health. In the following sections, proposals
for investigation and treatment of patients with amalgam-and
electricity-related disorders. These patient groups have much in common with
other patients with diffuse and obscure problems, where it can take a very long
time, sometimes several years before symptoms get an explanation of diagnosis.
This applies, for example, fibromyalgia and chronic fatigue syndrome. The
difference may be that these patients do not have their own definite opinion
about the cause. The common denominator is that they often feel badly treated
in health care, feel that they are not taken seriously, but is treated
casually. They are disappointed not to be believed and confirmed by the doctor.
As a patient, it is often an expectation to be healed. This places great
demands on the physician to create a relationship of trust with patients relate
their problems to amalgam or electricity, which may also be disappointed by
previous contacts with health care. Not least, it is important to give the
patient enough time, especially the first few times, then confidence will be
built up. Doctor listening skills put to the test. Time also needs to be
devoted to the preparation of the meeting with the patient, to sit in and evaluate
past records of investigations, opinions etc.. Doctor's attention, then during
the actual visit more undivided and actively devoted to contact with the
patient. The doctor also avoid unnecessarily duplicating previous studies and
treatment trials. Physician's attitude and approach to the patient's problems
are of great importance to the environment, such as Insurance, Employment and
relatives, perceived patient suffering. If the doctor shows that he respects
the patient's symptoms as real, reduces the risk that the patient is subjected
to slurs and treatment.
Sick
Existing
knowledge does not provide medical scientific data to describe the patient's
symptoms as amalgam or electricity-related. Nor is there any evidence that a
relationship can be excluded. When sick, the doctor should be clearly describe
the symptoms that constitute obstacle to working as well as present the study
findings presented. It is also of value to the patient's own views recorded.
Physician contact with insurance is important to clarify the medical assessment
of the patient's employment barriers and the measures that can be medically
justified for the rehabilitation of the patient.
Amalgam
and elsanering
Today is no
scientific basis for actively recommending amalgam removal sickness symptoms
other than the allergic reactions.
Scientific support is also lacking for elsanering. If thorough investigation
can not give any certain explanation to the patient's symptoms, and treatment
efforts have not been successful, you should be able to understand and accept
the patient wants to try other ways, such as amalgam or elsanering.
Continued
contact
It is important that the
physician provides continuing contact with the patient, even when treatment
options seemingly exhausted. If the bot does not exist, the physician's role is
to alleviate symptoms and support the patient. Further information is valuable
and even talk with the patient about what he or she can do to strengthen their
healthy sides and maintain their self-esteem, regardless of the cause of the
symptoms. It can be anything from getting enough sleep, exercise or relaxation
to avoid overtime or other commitments. This may seem obvious observations, but
is often not taken into account. In the continued contact, the physician must
also consider the renewal of history, assess changes in patient condition and
reconsider the diagnosis.
Continuity
High continuity of
medical contact should be sought. This provides better conditions for the
trusting patient-physician relationship, which is so crucial. In difficult
cases, it is important that the patient may be referred for professional and /
or environmental health or other specialty. The patient's regular doctor -
usually a general practitioner - should reconnect and responsibility for specialist
assessment. If confidence ceases between the patient and the doctor, he should
help the patient to get a new permanent physician. The same applies to
dentists.
Investigation and treatment of
patients with symptoms related to amalgam
The
section on treatment containing the advice of a more general nature. The
following practical advice in terms of contact with patients relating their
problems to amalgam.
Listen,
respect
A fundamental
prerequisite for being able to help these patients, the doctor can listen, take
the patient seriously and confidence. The patient must be given time to
describe its various symptoms and also feel that the doctor respects the
patient's own perception of the cause of the symptoms. Physicians must
understand that the patient may feel concern for severe underlying disease or
have concerns about the unknown or difficult to explain. , it is important that
the patient be informed of his right to have a comprehensive investigation and
assessment so that significant diseases are not overlooked. The patient must
feel that the physician believes that the patient's complaints and symptoms are
real even if a certain explanation for the disorder can not be given.
Troublesome
Picture
Most patients report a
variety of general symptoms but also local trouble from the mouth, teeth or
chewing apparatus. The patient need not relate any problems to amalgam. most
common problems for which patients are looking for are as follows: General
weakness and severe fatigue Diffuse pain Pain or stiffness in muscles or joints
Dizziness Headaches Difficulty concentrating and poor memory scurrying or sore
teeth Metallic taste Dry mouth sores or blisters in mouth soreness and bleeding
from the gums pain and suffering in the face and jaw
Draft
report
Current problems
Each symptom is
described thoroughly with onset and progression. Ongoing medication is noted as
the patient's own measures to relieve discomfort and possible effects of these.
Past medical history , both medical and dental health history demand with
inventory of past serious illnesses and injuries, possible hospitalization,
investigations and treatments. Medication including the use of herbal
penetrated. Suspected or confirmed hypersensitivity / allergy to medicines or
other substances noted.
Social
situation
It is important to gain
an understanding of the social situation and the stress factors that can affect
the course of disease, such as duplication of work, overtime, unemployment and
tobaks-/alkoholbruk.
Physical
examination
Carefully somatic status
are always including the mouth and teeth.
Laboratory
Tests
The following tests may
be considered in the basal study: blood count, SR Serum Iron B12/folsyra
electrolytes including calcium serum creatinine Liver Samples S-glucose
Thyreoideaprover Urine status may be additional samples after clinical
suspicion, eg Lyme disease or virusserologi. Determination of mercury in blood
or urine does not make sense to perform routine and therefore not recommended.
Patients with amalgam-related complaints have not been shown to have elevated
levels of mercury and analysis therefore provides no guidance in this regard.
Elevated levels of mercury can be found in people who have occupational
exposure. Furthermore, teeth grinding and intense gum chewing, including
nicotine gum, give elevated values. In these cases, the analysis may be
warranted. For advice on sampling and interpretation of results in these cases,
contact with professional and / or environmental medical unit.
Differential
Diagnoses
Diagnoses to consider
depending on the clinical picture include follows: Neurological Disease
infection collagenosis Malignancy Malabsorption endocrine or metabolic disorder
mental disorder such as depression, anxiety, etc. Somatoformt syndrome
Dental
assessment
Dental assessment is
always included in the investigation. There are no current assessment, referral
should be made to the patient's regular dentist. A referral to a dentist may be
issues relating to such
·
・patient's previous dental health
history including actions
·
・current status of the tooth and
filling material, mucous,
·
・bites and chewing function, and
·
・dental assessment and treatment
plan.
In
consultation with the dentist can be referred to a dermatologist be considered
for any allergy testing in lichen or other change in the oral mucosa.
Revisit
It is important that the
patient will follow-up visit to the doctor to get information about different
findings. While normal findings are valuable to discuss. It can dispel concerns
about serious illness.
Treatment
Detected deficiencies
and diseases are treated conventionally by doctors and dentists. Other symptoms
and signs may be relieved with symptomatic treatment and continued support.
When
specific disease can not be detected
Experience shows that
the investigation in some cases can result in that no specific disease could be
detected. The patient's perception of symptoms caused by amalgam may remain and
the patient may be anxious amalgam removal. Doctor's task will then be to
provide information on what is currently known as science and proven
experience. This is described in more detail in the introductory section.
Amalgam
removal
In allergic changes in
the oral mucosa including lichen or other demonstrated hypersensitivity to
mercury is indication of amalgam removal. Investigation done by dermatologist
issuing the medical certificate of fitness to perform amalgam removal. general
symptoms At present there is no medically justified indications for amalgam
removal. Some patients report that they have been symptom-free or improved
after amalgam removal. Other patients have not experienced any improvement and
some have new problems. Patients should receive detailed information from both
physicians and dentists above. If the patient still wishes to undergo amalgam
removal, the patient should be respected for that decision. Physicians should
in these cases, a certificate that the patient is fully treated and medical
obstacles Ör amalgam removal exists or not. costs amalgam removal is governed
by dental insurance.
Investigation
and treatment of patients with symptoms related to electricity
Patients called and call
themselves and their condition in different ways. It's still about the same
thing or relationship, namely the various problems that are perceived to be
related to electricity and electrical appliances.
Terminology
The area described here
as elkänslighet has had a partly confusing terminology. Symptoms are sometimes
equated with those seen in allergies and intolerance. It is therefore certainty
as far as possible, use a terminology consistent with that used in adjacent
areas. Hypersensitivity is a generic term which means that it reacts with
symptoms upon contact with common substances under conditions that people in
general can withstand without trouble . The reaction can be caused by specific
immunological mechanisms (allergy), non-immunological mechanisms (unspecific
hypersensitivity, hyperreactivity) and specific chemical hypersensitivity. use
of the terms allergy and hypersensitivity thus requires tests available to
identify these conditions. For symptoms reported triggered by electromagnetic
fields are missing today proven testing method. Nor is there any evidence that
elkänslighet caused by specific immunological mechanisms, which is why the
terms allergy to electricity and electromagnetic hypersensitivity should be
avoided. To avoid a questionable use of the above defined terms can name
elkänslighet used in health care. Elkänslighet term then used to describe
individuals and groups who put their complaints in connection with electrical
equipment without opinion on causation. section on treatment containing the
advice of a more general nature. The following practical advice with regard to
contact with elkänsliga patients.
Listen,
respect
A fundamental
prerequisite for being able to help these patients, the doctor can listen, take
the patient seriously and confidence. The patient must be given time to
describe its various symptoms and also feel that the doctor respects the
patient's own perception of the cause of the symptoms. Physicians must
understand that the patient can feel the anxiety of the unknown and difficult
to explain. , it is important that the patient be informed of his right to have
a comprehensive investigation and assessment so that significant diseases can
not be overlooked. The patient must also know that the physician believes that
the patient's complaints and symptoms are real and not imagined even if a
certain explanation for the disorder can not be given. elkänsliga Some patients
find it difficult to seek medical attention for fear of getting sick of
elpåverkan of reception. As far as practicable should therefore ask for and
respond to the patient any desire to turn the computer on and off fluorescent
lamps, etc.. Examination with electrical apparatus, such as ECG, should not be
performed routinely but only when medically justified question, and in
consultation with the patient.
Troublesome
Picture
The elkänsliga represent
a very heterogeneous group, both in terms of description of the problems and
situations that trigger symptoms. Two main groups can be distinguished. The
largest group has been troublesome from the skin during VDU work. Patients
describe the redness, heat, and sometimes burning pain in the skin, especially
the face. Tingling and numbness occurs. Symptoms often resolve within a few
years and relatively good prognosis for this group. A smaller group has general
elkänslighet and except for any skin symptoms also general problems with
fatigue, concentration and memory problems, headaches, dizziness, palpitations
and sometimes pain. Less common symptoms include cover for the ears,
respiratory problems, localized joint pain and gastrointestinal problems.
Following VDU's close proximity to the fluorescent lights commonly reported
symptoms triggering situation. Other sources of complaints reported to be
television, electrical appliances, telephones, cars, trains and even sunlight.
Measurements of low-frequency electric and magnetic fields has not been
possible to predict where problems are most pronounced. The electromagnetic
spectrum can be measured and characterized in a very large number of different
ways. Today, however, lacking knowledge of the properties of electric and / or
magnetic fields that may involve risks and how the doses and exposure should be
valued. Further research is needed before measurements can be meaningful for
the assessment of individual cases. elkänsliga Some patients tell of unbearable
symptoms such as spikes of severe pain - if they do not avoid electrical
equipment and installation. It will be particularly difficult cases, looking to
elfri environment in caravans or cottages. Symptoms often interpreted as a
warning of the victims as many feel that the symptoms gradually worsened by repeated
complaints triggering situations.
Draft
report
Knowledge of
elkänslighet is now complete. Therefore hair investigation focused on
differential diagnosis, ie. trying to identify other possible causes of
symptoms picture, both individual and environmental.
Current
problems
Each symptom is
described thoroughly with onset and progression. The patient's experience of
triggering or adverse factors and the measures taken by the patient himself and
the effects of these noted.
Past
medical history
Medical medical history
sought in the usual way with the stock of past severe symptoms of illness and
injuries, any previous hospitalization, investigations and treatments. Current
medication and any hypersensitivity to drugs, also including herbal remedies,
or allergy noted.
Social
situation
Mapping of both
occupational history, working, working as family situation is essential.
Physical and psychosocial conditions, leisure, stress such as duplication,
overtime or unemployment, relationship disturbances at home and at work,
tobacco / alcohol use, etc. may be of importance.
Physical
examination
Carefully somatic status
is always carried out.
Laboratory
Tests
The following tests may
be considered in the basal study: blood count, SR Serum Iron B12/folsyra
Electrolytes with calcium serum creatinine Liver Samples S-glucose
Thyreoideaprover Urine status may be additional samples of clinical suspicion,
eg Lyme disease or virusserologi.
Differential
Diagnoses
The following diagnoses
may be considered depending on the symptoms: Skin diseases like eczema, rosacea
and other exanthem Allergies, asthma, bronchial hyperresponsiveness Anemia
Malabsorption Endocrine or metabolic disease Neurological Disease Infection
collagenosis Malignancy Psychiatric disorders such as depression, anxiety, etc.
Somatoformt syndrome Other environmental problems pictures
Occupational
Early contact is taken
with care, if any, for the analysis of safety-related measures. When
occupational missing may be addressed to professional and / or environmental
health unit for advice. All measures should always be done in close
consultation with the patient in accordance with the health care law.
Revisit
It is important that the
patient will follow-up visit to the doctor to get information about different
findings. While normal findings are valuable to discuss. It can dispel concerns
about serious illness.
Treatment
Detected deficiencies
and diseases are treated conventionally. Other symptoms and signs may be
relieved with symptomatic treatment and continued support. If the patient does
not feel able to withstand some electrical equipment or some environments, this
is something that must be taken into account as far as possible. When sickness
arises, it is certainty to have contact with care, when available. Other tasks
or shorter sessions may be sufficient to appeal shall pass.
When
specific disease can not be detected
In many cases, the
investigation no evidence of specific disease. In addition to skin lesions, it
is rare for clinical examination and laboratory tests shows no pathological
abnormalities. The patient's perception of symptoms caused by electricity may
remain and the patient may be anxious elsanering. Doctor's task will then be to
provide information on what is currently known as science and proven
experience.
Elsanering
It is not the job of the
physician to recommend about elsanering should be done. The scientific evidence
is mentioned uncertain. These issues must be dealt with by responsible employers
and municipalities, which in some cases have been awarded grants for home
modifications. At rehabilitation work, replacement of equipment, such as
fluorescent to incandescent lamps, cathode-ray screen to screen liquid crystal,
called LCD, included when the effects of different response. Some elsanering
are sometimes included as part of the measures. Pros and cons of planned
interventions should be carefully considered in each case, as well as how a
failure to improve will be handled. This guidance replaces s 1 through 4 of the
National Board of Health guidelines (SOSFS 1991:6) concerning the investigation
of patients who put their symptoms associated with mercury from amalgam. The
section General recommendations on the use of amalgam on page 5 is still
correct.