Risk profiling individuals will bring new responsibilities

Former editor, IOSH Magazine

The future of medicine, we are promised, will involve increasingly sophisticated tailoring of medication, with doses adjusted to our capacity to absorb them rather than the one-size-fits-most prescriptions of today.

At the International Commission on Occupational Health’s (ICOH) 2018 congress, Professor Antonio Mutti of the University of Parma in Italy explored the science of toxicogenomics and how adaptation or susceptibility to exposure to harmful substances may be passed on from parents to children.

Mutti suggested at some point profiling will be possible to identify individuals whose genome leaves them more than usually sensitive to a given substance, so they aren’t placed in harm’s way by exposure to levels an average person could tolerate.

Our efforts to identify propensity to conditions are pretty hit-and-miss at present as another ICOH speaker, Bradley Evanoff, pointed out in a presentation about prescreening employees for musculoskeletal disorders.

But they are likely to improve and to give us valuable data when they do.

Studies in the Czech Republic and in Turkey have found an unusual pattern among those infected with a common human parasite toxoplasma gondii. The protozoa cause only mild, flu-like symptoms at worst in their hosts on arrival and were thought to be asymptomatic afterwards, though they stay in any human or animal they infect for the rest of the host’s life.

The Czech and Turkish researchers studied people who had crashed their cars but had not consumed alcohol and in both cases found a very high incidence of those infected with gondii.

More research is under way to see whether the link between the parasite and susceptibility to road accidents can be firmed up and whether it’s possible to find a causative relationship. If that link is proven it’s something that should interest OSH managers, since an estimated one in three people in developed countries is infected with gondii.

There are concerns about the possibility that individual genetic profiles could make it easier for insurers to exclude swathes of people from health cover. Likewise, the more we know about individual characteristics and sensitivities, whether inherited in our genes or acquired through what is called the exposome, the sum of our exposures, the greater the risk for people to find themselves shut out of occupations or the workforce through no fault of their own.

As with so many things, the technology may run ahead of our protocols for its best and fairest use. But while we treat all employees as equally at risk, or equally safe, we are only seeing part of the picture.


Louis Wustemann is former editor, IOSH Magazine. He was previously editor of Health and Safety at Work magazine and Environment in Business. He has written, edited and consulted on health and safety, environmental and employment matters for more than 25 years.

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