Abstract
This article is intended to acquaint those whose principal concerns are the health and safety of workers with genetic screening and some of the medical and ethical issues it raises. Population-based genetic screening increasingly is being considered for predicting future disease in the person being screened. A major problem in screening for alleles that contribute to the development of common, multifactorial disorders is low sensitivity and positive predictive value. In many instances, no demonstrably effective prophylaxis or treatment is available to help those with positive test results. This creates ethical problems of assuring that testing is in the person's best interest and raises in turn issues of autonomy, discrimination, and privacy. Instead of screening for genetic predispositions to harm from workplace exposures, other means of improving the health of workers may bring greater benefits to a higher proportion of workers. The current state of genetic tests for chronic beryllium disease are considered. None are suitable for screening.
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Selected References
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- Babul R., Adam S., Kremer B., Dufrasne S., Wiggins S., Huggins M., Theilmann J., Bloch M., Hayden M. R. Attitudes toward direct predictive testing for the Huntington disease gene. Relevance for other adult-onset disorders. The Canadian Collaborative Group on Predictive Testing for Huntington Disease. JAMA. 1993 Nov 17;270(19):2321–2325. [PubMed] [Google Scholar]
- Eisenbud M. Re: Lung cancer incidence among patients with beryllium disease. J Natl Cancer Inst. 1993 Oct 20;85(20):1697–1699. doi: 10.1093/jnci/85.20.1697. [DOI] [PubMed] [Google Scholar]
- Holtzman N. A., Rothstein M. A. Eugenics and genetic discrimination. Am J Hum Genet. 1992 Mar;50(3):457–459. [PMC free article] [PubMed] [Google Scholar]
- Holtzman N. A. What drives neonatal screening programs? N Engl J Med. 1991 Sep 12;325(11):802–804. doi: 10.1056/NEJM199109123251109. [DOI] [PubMed] [Google Scholar]
- Kreiss K., Miller F., Newman L. S., Ojo-Amaize E. A., Rossman M. D., Saltini C. Chronic beryllium disease--from the workplace to cellular immunology, molecular immunogenetics, and back. Clin Immunol Immunopathol. 1994 May;71(2):123–129. doi: 10.1006/clin.1994.1061. [DOI] [PubMed] [Google Scholar]
- Kreiss K., Wasserman S., Mroz M. M., Newman L. S. Beryllium disease screening in the ceramics industry. Blood lymphocyte test performance and exposure-disease relations. J Occup Med. 1993 Mar;35(3):267–274. [PubMed] [Google Scholar]
- McEwen J. E., Reilly P. R. State legislative efforts to regulate use and potential misuse of genetic information. Am J Hum Genet. 1992 Sep;51(3):637–647. [PMC free article] [PubMed] [Google Scholar]
- Natowicz M. R., Alper J. K., Alper J. S. Genetic discrimination and the law. Am J Hum Genet. 1992 Mar;50(3):465–475. [PMC free article] [PubMed] [Google Scholar]
- Rossman M. D. Chronic beryllium disease: diagnosis and management. Environ Health Perspect. 1996 Oct;104 (Suppl 5):945–947. doi: 10.1289/ehp.96104s5945. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rothstein M. A. Genetic testing: employability, insurability, and health reform. J Natl Cancer Inst Monogr. 1995;(17):87–90. [PubMed] [Google Scholar]
- Tambor E. S., Bernhardt B. A., Chase G. A., Faden R. R., Geller G., Hofman K. J., Holtzman N. A. Offering cystic fibrosis carrier screening to an HMO population: factors associated with utilization. Am J Hum Genet. 1994 Oct;55(4):626–637. [PMC free article] [PubMed] [Google Scholar]
