Genetic screening/testing is defined as the analysis of human genetic material (such as DNA, RNA, chromosomes, proteins, and certain metabolites) to determine predisposition to a particu- lar health condition or to confirm a diagnosis of genetic disease. Genetic monitoring is the periodic evaluation of genetic material or somatic or germline DNA to assess whether exposures or health effects are likely to have occurred. It involves the peri- odic examination of employees to evaluate changes to their genetic material, such as chromo- somal damage or evidence of increased occurrence of mutations, which may have developed from exposure to toxic substances in the workplace. With the completion of the Human Genome Project, it is likely that genetic screening and monitoring to detect diseases or increased susceptibility to diseases will increase. Genetic test- ing for inherited genetic variants is performed for several purposes, such as diagnosis of indi- viduals with symptoms, diagnosis and surveillance of occupational disease, determination of future disease risks in asymptomatic individuals, determination of genetic risks for children, guidance of medical treatment, detection of biomarkers to predict individual susceptibility to disease or toxin exposure, and research. However, genetic screening is complex and raises sig- nificant legal and ethical concerns in the workplace including adverse impacts on worker insurability and employability, worker privacy and confidentiality, as well as quality of life. Although the use of emerging genetic technologies and information in the workplace may ben- efit worker health and safety, it must be applied in a way that is legally, ethically, and socially acceptable. The results of genetic tests are not easy to interpret and explain, taking into consideration a per- son’s medical history, family history, and type of genetic test that was done. A positive test of a predictive or presymptomatic genetic test usually cannot establish the exact risk of developing a disorder. A positive test cannot be used to predict the course or severity of a condition. A negative result means the laboratory did not find a dangerous copy of the gene, chromosome, or protein under consideration, meaning the person is not affected by a particular disorder, is not a carrier of a specific genetic mutation, or does not have an increased risk of developing a certain disease. Further testing may be needed to confirm a negative result. Before implementing genetic screening in the workplace, a sound policy with appropriate safe- guards needs to be in place. Areas to consider include conducting the screening in accordance with legal, ethical standards, and principles including informed consent ensuring the quality, reliability, and validity of the screening tests and the performing laboratory exercising caution in the use and interpretation of the tests discussing the results and what they mean with an appropriately trained health professional or genetic counselor knowing the cost of the test ensuring the confidentiality of the health information and preventing discrimination in employ- ability and insurance. 248 Definition and Purpose Program Objectives and Elements Genetic Screening and Monitoring
Previous Page Next Page