Genetic screening and occupational and environmental exposures.

but policies based on freedom of choice divorced from an awareness of the broader social context have the potential to favour the wealthy, the highly educated, and the genetically healthy. Not everyone, for example, has the choice about where they are going to work—lack of skills, lack of mobility, living in an area of high unemployment, and so on may make it impossible for those who are rejected from local employment to find such employment elsewhere. Secondly, in addition to its potential to lead to increased discrimination, the use of genetic screening in the workplace may lead to an increased likelihood of invasions of the privacy and confidentiality of workers; for example, in the writing of references, the provision of information for the purposes of insurance, and so on. Furthermore, the standards of security and confidentiality in relation to the use of genetic information and samples may be less rigorously monitored in the context of employment than in, for example, medical research. Indeed, examples already exist of samples being tested for outcomes other than that for which they were taken; for example, in the case of Norman-Bloodsaw v Lawrence Berkeley Laboratory employees provided blood and urine samples for cholesterol testing, but in fact some of 659 EDUCATION www.occenvmed.com group.bmj.com on October 28, 2017 Published by http://oem.bmj.com/ Downloaded from