When Scientific Knowledge and Ignorance Make It Difficult to Improve Occupational Health: A French and European Perspective

Abstract

This article analyzes the consequences of the increasing reference to scientific expertise in the decision and implementation process of occupational health policy. Based on examples (exposure limits and attributable fractions) taken from an interdisciplinary seminar conducted in 2014 to 2015 in France, it shows how the measurement or regulation of a problem through biomedicine-based tools produces blind spots. It also uses a case study to show the contradictions between scientific and academic aims and public health intervention. Other indirect implications are also examined, such as the limitation of trade unions’ scope for action. Finally, the article suggests launching a broad political debate accessible to nonspecialists about collective occupational health issues—a dialogue made difficult by the rise of the afore-mentioned techno-scientific perspective.

Contribution of causal factors to disease burden: how to interpret attributable fractions

“…The later misuse of PAFs or the more specific probability of causation metric may raise even greater problems where knowledge on biological mechanisms as well as epidemiological/exposure data are not sufficient to frame the question and answer it adequately. Beyond the scientific difficulties in documenting complex industrial and environmental hazards over long periods of time, we should keep in mind what science and technology studies have taught us: that undone science and the production of ignorance are narrowing the definition of problems and shaping blind spots that complicate the improvement of public health, PAFs being one good example [ 51 ].…”

The role of evidence in occupational safety and health

“…The role and influence of trade unions vary greatly by country [55]. Evidence sharing by intermediary bodies…”

“…Worker/employee engagement is an important contributor to an organisation's safety culture [31,36,37,41,42,44,46,48,54,55]…”

“…Assessing the feasibility of different intervention strategies before taking action [49] viii. Managing workers' exposure to hazards [55] ix. Informing changes in organisational processes and procedures [39,45] [INT02]…”

“…Identifying vulnerable worker groups and targeting efforts [36] xi. Developing occupational exposure limits [53,55] xii. OSH regulation development [31] [INT07].…”