The high-risk occupational disease notification and prevention act. From primary to secondary prevention - from paternalism to autonomy.
Ann NY Acad Sci 1989 Dec; 572:151-154
The High Risk Occupational Disease Notification and Prevention Bill was discussed. The bill represented a dramatic break with past efforts in the area of occupational health. Rather than attempting to eradicate disease through primary prevention, it placed the onus on exposed workers to act to protect themselves. In so doing, it created a more significant and responsible role for employees than that recognized by prior legislation. These moves toward secondary prevention and worker autonomy constituted major changes in the way the federal government approaches workplace health, moves that require thorough thought and analysis. The basic mechanism of the bill was one of identifying occupational health risks and then notifying the workers who are at risk. On the basis of the information provided them, workers can then decide on an appropriate course of action for detection and, if necessary, treatment for the disease in question. Problems of interpretation may arise in cases in which the process diverges from the prototypical one such as the treatment of subclinical pathophysiologic changes in which the relation between the change and the risk of disease is not clear. A second difficulty concerned establishing which exposures trigger notification. Another difficulty concerned the ability of the system to deal with damage from paraoccupational exposures, injury or disease occurring in family members who may be considered in privity of employment with their exposed relative who brings the hazard home.
NIOSH-Publication; Legislation; Occupational-exposure; Industrial-hazards; Occupational-diseases; Regulations; Risk-analysis; Worker-health; Occupational-health-programs
Annals of the New York Academy of Sciences