16 April 2011

Unhealthful News 106 - Occupational hazards

Occupational health research is valuable in epidemiology not just because it helps protect workers from hazards, but because the health outcomes of workers – who often exposed to a lot more of something than people are in their homes or from the environment – can be warnings that an exposure is hazardous though we cannot detect an effect at low levels.  Similarly, it can provide reassurance that an exposure is not very hazardous.  But much of the field work strikes me as particularly unpleasant, combining some of the the downsides of bench science (e.g., taking careful physical measurements of the same thing over and over and over again) with those of behavioral epidemiology and medical field work (e.g., trying to get people to take the time to participate, getting honest and careful answers to questions, and perhaps messing with icky biological samples), with the added bonus of having to travel to job sites that might be on one of those "I am sure glad I don't have to do that" televisions shows, hanging out in places the require lots of safety equipment.

I remember once, while attending a talk about an occupational health study with excruciatingly detailed methodology reporting, that I embarrassed a colleague by prompting him to laugh out loud by whispering to him, "every time she says 'and then we…', I find myself thinking 'I am so glad I am not you'."  I recall that my main motivation was that it sounded excruciatingly tedious, with enough ickiness to make it worse than a boring office job.

The occupational health story in the news today is about a rather less tedious investigation, though one that seems like it might be even less pleasant field work:
Health officials stymied in porn investigation
Associated Press
LOS ANGELES (AP) — Health officials say porn producers are dodging questions and slowing down an investigation into a case of HIV that shuttered production at several companies last year.
The Los Angeles Times reports that health officials are struggling to make headway on a probe, a process that is usually much more efficient when there is a disease outbreak.
The LA Times story itself goes into great detail about the potential pathways via which the disease might have spread (I recommend reading it only if you hate porn and are looking for additional reasons to be queasy about it).  It summarizes a lot of investigative effort that apparently ran into dead ends due to a lack of cooperation, and mentions the mysterious cancellation of the plan to present a report about the matter at a CDC conference this week.

I do not have any great scientific insight about this.  It just struck me as an interesting mix of occupational health research and infectious outbreak investigation.  Because the outbreak aspect is so much more exciting, it seems to have overshadowed the occupational side (i.e., how can working conditions be changed so this does not happen again).  Though what struck me the most is wondering why several public health agencies are banging their heads against the wall to investigate this incident, facing great resistance from those they are trying to help, and highlighting it as a major-report-worthy event.  Sure, it is important for the people involved, but it is more of a personal medical issue, a matter for the industry to devote resources to, and perhaps a police matter if there is a cover-up.  It does not seem to call for quite so much time and effort from overstretched public health resources.  There are a lot more people at high risk for catching HIV that could benefit from this attention.

Finally I could not help but notice that every version of the news story used the word "probe".  But mine was the only one that also used "banging" and "overstretched", so I win.

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