Response to qualms about medical screening as a discriminatory tool

Our plain-English summary of Response to qualms about medical screening as a discriminatory tool, by F.M. Kogan, E.V. Polzik (American Journal of Industrial Medicine, 1991).

The study

• Authors: F.M. Kogan, E.V. Polzik
• Journal: American Journal of Industrial Medicine
• Published: 1991;20(2):273-4
• Type of article: Comment, Letter
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a research study. The authors, from a medical centre in Sverdlovsk, USSR, were responding to Dr. Susan M. Kennedy's 1991 objections to medical screening that selects job applicants who are less sensitive to a workplace hazard. The authors argued that such selection should not replace efforts to improve working conditions but should be a necessary supplement to them until those efforts are shown to be insufficient to completely exclude the risk under consideration. They stated that in their experience, 25 years of efforts in asbestos-textile factories, where dust levels were below the official maximum allowable concentration, did not protect workers from increased lung cancer risk. They gave no figures for this, and from it they concluded that these workers were highly susceptible to asbestos. They pointed to existing legal bans on child labor and on women's underground work, and to the healthy worker effect, to support some rational control of selection. They also noted that a recommendation to avoid asbestos work may close off two to three occupations.

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: Letter to the editor (opinion piece responding to another author); no new study or data
• Who was studied: No population was studied. The authors referred, without figures, to workers in asbestos-textile factories from their own experience at a medical centre in Sverdlovsk, USSR.
• Exposure: Asbestos dust in asbestos-textile factories at levels below the official maximum allowable concentration. No fiber type or dose figures were given.
• Main results:
  • The authors stated that, in their experience, 25 years of efforts in asbestos-textile factories with dust below the official limit did not protect workers from increased lung cancer risk. No numbers were given.
  • From this experience, the authors inferred that these workers were highly susceptible to asbestos.
  • The authors cited the healthy worker effect as evidence that natural selection of more resistant workers already occurs.
  • As examples of accepted legal employment restrictions, the authors cited bans on child labor in industry and on women's underground work.
  • The authors noted that a recommendation to avoid asbestos work may close off two to three occupations, and asked whether this is comparable to advising against childbearing.
• The authors' conclusion: The authors argued that selecting less sensitive individuals is justified as a necessary supplement to, not a replacement for, improving working conditions, until those improvements are shown to be insufficient to completely exclude the risk under consideration.

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