Implications of the Human Genome Project on the 21st century workplace will carry practical and ethical consequences for employers and employees, according to a genetic expert who spoke Wednesday at the American Industrial Hygiene Conference & Exposition (AIHce) in New Orleans.
Alan M. Guttmacher, M.D., senior clinical adviser to the director of the National Human Genome Research Institute, part of the National Institutes of Health in Washington, D.C., explained that genomics, or "new genetics," provides knowledge of individual genetic predispositions in humans. This knowledge, he said, can have a positive impact by allowing people to use medications to prevent or delay genetic-related illnesses, such as taking anti-hypertensive agents before hypertension develops.
"A genomic approach to medicine emphasizes disease prevention and health maintenance rather than disease treatment," Guttmacher said.
Genetic testing, for example, would allow employers to use a person''s genetic makeup to predetermine whether a worker is susceptible to a particular injury or illness. "This will help you think about workplace risks to the individual rather than to categories of workers, whether it be chemical or other kinds of exposures," he said.
The problem, Guttmacher said, is that there are ethical implications to genetic testing. "What happens when an employer wants to treat workers different because of their genetic makeup and their likelihood to develop a workplace-related injury or illness?"
This happened recently with Burlington Northern Santa Fe (BNSF) Railroad, which demanded that employs applying for workers'' compensation for carpal tunnel syndrome (CTS) undergo genetic testing to determine whether they had a genetic cause for CTS.
From a scientific viewpoint, the company faced a number of problems, Guttmacher said. For one thing, even though people with the mutant gene are at a higher risk for carpal tunnel syndrome, not everyone with the gene develops CTS. In addition, such mutations are relatively rare.
Instead of proceeding with genetic testing, BNSF settled a lawsuit filed by the Equal Employment Opportunity Commission contending the testing violated the Americans with Disabilities Act. The company, which admitted it tested certain employees for a genetic marker, "agrees it will not request employees to undergo genetic tests, will not discipline any employees for refusal to submit to genetic testing and will preserve all records in its control."
Complicated social issues with using genetic testing raise many issues that have no easy answers, Guttmacher said. Does an employer have the right to demand that employees learn medical information they may not want to know about and that may have implications for other family members? Will genetic information gathered by an employer influence hiring, retaining and promoting employees? Will genetic information be shared with insurers?
While it may be hard to overcome the many ethical implications to genomic medicine and its impact on the workplace and society, Guttmacher believes there are many positive reasons to accept genetic testing, such as helping cure diseases. He noted former President Clinton''s comment on June 26, 2000, in announcing the completion of the human genome draft sequence: "It is now conceivable that our children''s children will know the term ''cancer'' only as a constellation of stars."
by Todd Nighswonger