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policies and interventions<br />

to reduce risks associated with that work. in these situations of<br />

exploitation and domination of labour, workers weigh the cost (e.g., an<br />

injury) versus the benefit (money) of working in these jobs.<br />

second, when scientists and experts do become involved, it is easy<br />

to discredit or manipulate findings to support the firm's position. in the<br />

end, those in control of capital are in a better position to provide<br />

counter-opinions due to the structural imbalance of power, that is, of<br />

wealth and influence. This firm-level analysis can also be extended to<br />

the whole economy to explain the current economic crisis, which has<br />

been fuelled by decades of deregulation. Workers' health is commonly<br />

defined by the scientific community as a technical problem, and<br />

conflicts over workplace hazards are typically referred to "experts"<br />

who determine whether particular work processes or substances are<br />

hazardous to health. for example, mainstream scientific knowledge<br />

commonly denies the validity of alternative evidence found in shop<br />

floors by unions or safety representatives. at the same time, definitions<br />

of occupational health by many physicians often adapt to a firm's<br />

needs, serving to reinforce the domination of labour by capital. in fact,<br />

several studies have documented how experts employed by companies<br />

have withheld information, lied, distorted findings, or used poor<br />

methodologies to serve the interests of their employers (Berman,<br />

1978; Berlinguer, falzi, & figa-Talamanca, 1996; Messing, 1999).<br />

in both these ways, the conflict of interests between the<br />

responsibility for profit-maximisation and the domination of the<br />

workers often favours the employer's benefits over the safety of the<br />

employee. Governments often wish to adopt a neutral role,<br />

mediating conflicts between workers and companies and, along with<br />

experts and employers, determining the nature of a safe workplace<br />

environment. But even this safety does not imply the absence of<br />

risk. it merely defines what is "acceptable" (Walters, 1985).<br />

acknowledging this underlying political and ideological conflict over<br />

workers' health is a necessary step to the process of understanding<br />

occupational health policy (Muntaner et al., 1998; Benach,<br />

Muntaner, Benavides, amable, & Jódar, 2002).<br />

mobile occupational medicine unit. port of<br />

Genoa (italy).<br />

source: © ilo/M. crozet (2008)<br />

9.2. Macro policies and healTh: an hisTorical<br />

perspecTive<br />

This book has charted in previous chapters the health impacts of six<br />

specific employment dimensions: full-time permanent employment,<br />

unemployment, precarious employment, informal work, child labour<br />

and slavery (see section 7.3). To further understand their effects on<br />

workplace health, each must be viewed in a historical context.<br />

291

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