PRINCIPLES OF TOXICOLOGY

508 OCCUPATIONAL AND ENVIRONMENTAL HEALTH
Occupational health policies can have a major effect on people’s employment and require careful
consideration of fairness and equity.
Informed consent is generally accepted as a fundamental element of medical ethics. In general
medical care, patients cannot be coerced into accepting tests and treatments. The same is true in the
workplace setting, but this principle sometimes clashes with job requirements. For example, employers
can compel employees to submit to drug testing, within certain guidelines. Occupational health
illustrates the difficulty of balancing individual autonomy with the requirements of employers and
government.
Several professional groups have issued codes of ethics for occupational health practice. The most
widely accepted is the International Code of Ethics of the International Commission of Occupational
Health (ICOH), issued of 1992. Selections from this Code are presented here:
• Duties and obligations of occupational health professionals
• a. Knowledge and expertise. Occupational health professionals must continuously strive
to be familiar with the work and the working environment as well as to improve their
competence and to remain well informed in scientific and technical knowledge, occupational
hazards and the most efficient means to eliminate or to reduce the relevant risks. Occupational
health professionals must regularly and routinely, whenever possible, visit the
workplaces and consult the workers, the technicians, and the management on the work
that is performed.
• Commercial secrets. Occupational health professionals must not reveal industrial or commercial
secrets of which they may become aware in exercising their activities. However, they
cannot conceal information that is necessary to protect the safety and health of workers or
of the community. When necessary, the occupational health professionals must consult the
competent authority in charge of supervising the implementation of the relevant legislation.
• Information to the worker. The results of the examinations, carried out within the framework
of health surveillance, must be explained to the worker concerned. The determination
of fitness for a given job should be based on the assessment of the health of the worker and
on a good knowledge of the job demands and the worksite. The workers must be informed
of the opportunity to challenge the conclusions concerning their fitness for work that they
feel are contrary to their interests. A procedure of appeal must be established in this respect.
• Condition of execution of the function of occupational health professionals
• Professional independence. Occupational health professionals must maintain full professional
independence and observe the rules of confidentiality in the execution of their
functions. Occupational health professionals must under no circumstances allow their
judgment and statements to be influenced by any conflict of interest, in particular when
advising the employer, the workers, or their representatives in undertaking on occupational
hazards and situations that present evidence of danger to health or safety.
20.7 SUMMARY AND CONCLUSION
Occupational and environmental illnesses include a wide range of health conditions.
• These are common, with an estimated 300,000 new cases annually in the United States.
• These include pulmonary, dermatologic, muscoskeletal, neurologic, and reproductive conditions,
as well as cancers and others.
• Cases of occupational and environmental illness are usually clinically indistinguishable from
cases of the same illness that are not exposure-related.
• Occupational and environmental illnesses are highly preventable.