Occupational and environmental medicine: moving the factory fence or hedging our bets?

Our plain-English summary of Occupational and environmental medicine: moving the factory fence or hedging our bets?, by P.G. Lewis (Occupational Medicine, 2000).

The study

• Author: P.G. Lewis
• Journal: Occupational Medicine
• Published: 2000;50(4):217-20
• Type of article: Review
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Occupational and environmental medicine evolved out of concern for the effect of work hazards on health. The experienced gained in considering such hazards has been extended to understanding general risks in the environment. As we look toward the future, classical occupational and environmental hazards such as over exposure to lead, asbestos and mercury are waning and being replaced by concerns around sustainable development, toxicology testing and exposure information for high production volume chemicals, development of better approaches for setting workplace and community exposure limits, environmental justice and many others. The opportunities for the future exist in overcoming these new challenges.

In plain English

This 2000 article, labelled an "in-depth review", was a commentary by an author at the Rohm and Haas Company in Philadelphia on the future of occupational and environmental medicine. It reported no new research data and did not describe a systematic review of other studies. Asbestos came up only in passing. The author wrote that poisoning from lead, asbestos and mercury was waning, and that classic hazards were well known and fairly well understood, leaving mainly a "mopping-up action". The author also noted that some countries and work areas still faced threats from heavy metals, pesticides and mining hazards. The rest of the article covered newer concerns: sustainable development, toxicology testing of high production volume chemicals, a quantitative risk approach to setting exposure limits, debates about low-dose effects, publishing exposure levels on material safety datasheets, environmental justice, and ergonomics. The author concluded that attending to these areas would require the specialty to go beyond the factory fence, and that this would hedge its bets against irrelevance and obsolescence. The article gave no findings on asbestos disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Commentary or opinion piece, published under the heading 'in-depth review'. It presents no original data and describes no systematic search of the literature.
• Who was studied: No study population. The piece is a discussion of the field of occupational and environmental medicine, written by an author at Rohm and Haas Company, Philadelphia, USA.
• Exposure: No specific exposure was studied. Asbestos is mentioned only in passing, alongside lead and mercury, as a classical hazard the author described as waning. No fiber types, products, jobs or doses are discussed.
• Main results:
  • The author argued that classic industrial and environmental hazards are well known and fairly well understood, and that the remaining challenge is mainly a 'mopping-up action'.
  • The author noted that threats from heavy metals, pesticides and mining hazards still exist in some countries and in selected work areas of nearly every country.
  • The author described sustainable development as the source of both challenges and opportunities for the specialty.
  • The author described an agreement between the US EPA and the Chemical Manufacturers' Association to complete screening tests for about 3000 high production volume chemicals by 2004.
  • The author expected a quantitative risk approach to setting exposure limits to be explored, in place of the traditional safety factor approach.
  • The author described endocrine disruption, multiple chemical sensitivity and hormesis as debates about effects at exposure levels below those normally tested.
  • The author expected debate over how far companies should be required to publish exposure levels on material safety datasheets.
  • The author expected environmental justice problems to concern most nations for the foreseeable future.
  • On ergonomics, the author noted continuing controversy over reliable diagnostic criteria and effective treatments.
• The authors' conclusion: The author concluded that attending to these developing areas of concern would require occupational and environmental medicine to go beyond the factory fence, and that doing so would hedge the specialty's bets against irrelevance and obsolescence.

Related studies

• The 10-year experience of an academically affiliated occupational and environmental medicine clinic — L. Rosenstock, W. Daniell, et al. (1992)
• Environmental history of a factory producing friction material — J.W. Skidmore, B.L. Dufficy (1983)
• Children's environment in Central Europe: threats and chances — S. Böse-O'Reilly, U. Heudorf, et al. (2007)
• Not just a research method: If used with caution, can job-exposure matrices be a useful tool in the practice of occupational medicine and public health? — M. Fadel, B.A. Evanoff, et al. (2020)
• Position Paper on Asbestos of the Italian Society of Occupational Medicine — P. Apostoli, P. Boffetta, et al. (2019)
• Classical syndromes in occupational medicine: the Montague Murray case — M. Greenberg (1982)

Browse more research in Occupational Medicine, or return to medical research.