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Quantifying the advantages and disadvantages of pre-placement genetic screening

Quantifying the advantages and disadvantages of pre-placement genetic screening
Quantifying the advantages and disadvantages of pre-placement genetic screening
BACKGROUND: Tests of genotype may enable workers at unusual risk of future ill-health to be identified. Using them to select for employment, however, entails gains and losses to employers and employees. Ensuring a fair balance between the rights and obligations of each group requires a value judgement, but the advantages and disadvantages to interested parties must first be quantified in a meaningful way.
METHOD AND RESULTS: The purposes of pre-employment screening are reviewed, and several simple measures relevant to the separate interests of employers and job applicants proposed-number screened to prevent a single adverse outcome; number excluded to prevent a case; expected incidence of the adverse outcome in those excluded; and preventable fraction. The derivation of these measures is illustrated, and the factors that influence them (the prevalence of the prognostic trait, the relative risk that it carries for an adverse outcome, and the overall incidence of disease) are related algebraically and graphically, to aid judgement on the utility of screening under different circumstances.
CONCLUSIONS: In sensitive areas such as genetic testing the onus should be on the employer to justify plans for pre-placement screening. Several quantitative measures can be used to inform the ethical and economic debate about screening and to evaluate alternative strategies for prevention.
prevalence, genotype, personnel selection, economics, epidemiology, genetic predisposition to disease, cost-benefit analysis, occupational health services, medical, humans, disease, risk, incidence, environmental, ethics, employment, genetic screening
1351-0711
448-453
Palmer, K.T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Poole, J.
d6c5377d-ac31-4552-8108-e5bd16f9fd00
Rawbone, R.G.
096202ad-5f47-4ecb-b12f-5c191e0e0e7f
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Palmer, K.T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Poole, J.
d6c5377d-ac31-4552-8108-e5bd16f9fd00
Rawbone, R.G.
096202ad-5f47-4ecb-b12f-5c191e0e0e7f
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3

Palmer, K.T., Poole, J., Rawbone, R.G. and Coggon, D. (2004) Quantifying the advantages and disadvantages of pre-placement genetic screening. Occupational & Environmental Medicine, 61 (5), 448-453. (doi:10.1136/oem.2002.005611).

Record type: Article

Abstract

BACKGROUND: Tests of genotype may enable workers at unusual risk of future ill-health to be identified. Using them to select for employment, however, entails gains and losses to employers and employees. Ensuring a fair balance between the rights and obligations of each group requires a value judgement, but the advantages and disadvantages to interested parties must first be quantified in a meaningful way.
METHOD AND RESULTS: The purposes of pre-employment screening are reviewed, and several simple measures relevant to the separate interests of employers and job applicants proposed-number screened to prevent a single adverse outcome; number excluded to prevent a case; expected incidence of the adverse outcome in those excluded; and preventable fraction. The derivation of these measures is illustrated, and the factors that influence them (the prevalence of the prognostic trait, the relative risk that it carries for an adverse outcome, and the overall incidence of disease) are related algebraically and graphically, to aid judgement on the utility of screening under different circumstances.
CONCLUSIONS: In sensitive areas such as genetic testing the onus should be on the employer to justify plans for pre-placement screening. Several quantitative measures can be used to inform the ethical and economic debate about screening and to evaluate alternative strategies for prevention.

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More information

Published date: 2004
Keywords: prevalence, genotype, personnel selection, economics, epidemiology, genetic predisposition to disease, cost-benefit analysis, occupational health services, medical, humans, disease, risk, incidence, environmental, ethics, employment, genetic screening

Identifiers

Local EPrints ID: 62030
URI: http://eprints.soton.ac.uk/id/eprint/62030
ISSN: 1351-0711
PURE UUID: aa428665-2435-4dd5-a706-697398a60dfd
ORCID for D. Coggon: ORCID iD orcid.org/0000-0003-1930-3987

Catalogue record

Date deposited: 09 Sep 2008
Last modified: 16 Mar 2024 02:53

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Contributors

Author: K.T. Palmer
Author: J. Poole
Author: R.G. Rawbone
Author: D. Coggon ORCID iD

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