The Contribution of Health Professionals to the Creation of Occupational Health Standards: The Impact of Professional Ethics in the Case of Asbestos

Abstract

ln the Netherlands, as in other Western countries, there is a great time lag between the evidence of the carcinogenicity of asbestos (1949) and the launching of first legislation that reduces the occupational exposure (1971) and finally, the complete ban of the production and application of asbestos (1993). So, between 1949 and 1970 there was a serious health risk while effective protective regulations were lacking. This implied a serious ethical dilemma for occupational health professionals: according to their code of ethics, they ought to contribute to a safe and healthy working environment while companies are not strictly obliged to do so. This study explores retrospectively the position of health and safety professionals with regard to asbestos between 1930 and 1990; specifically with respect to the prevention of harmful health effects for exposed workers, which is a central value in their professional ethics. It turns out that the associations of safety and health professionals did not promulgate any position on the prevention of harm due to asbestos. Nor did the uncertainty about the health impact of asbestos obviously cause an ethical dilemma for individual professionals. Professionals were usually involved in discussions on diagnostic methods of asbestos exposure in the human body (X-ray or detection in sputum), the existence of safe limits, the scientific basis of risk assessment and effective prevention strategies. Only a single professional was seeking attention to the severe health risks and advocated for preventive action.