[Causality and responsibility in occupational health]

Area of Science:

• Occupational Health
• Epidemiology
• Public Policy

Background:

• The relationship between causality and responsibility in occupational health is often imperfect, particularly in preventing work-related illnesses and injuries.
• Epidemiology demands rigorous internal and external validity when establishing causal relationships, yet a purely biomedical focus can lead to overlooking broader economic and political determinants.
• Governance structures (administrations, companies, governments) must translate evidence into policies and legal norms, often navigating complex participatory processes and conflicting interests.

Purpose of the Study:

• To review the imperfect relationship between causality and responsibility in occupational health.
• To advocate for a multidisciplinary approach that integrates epidemiological rigor with economic and political considerations.
• To emphasize the role of governance in assuming responsibility for preventive measures.

Main Methods:

• Literature review and conceptual analysis.
• Examination of the tension between establishing causality in epidemiology and assigning responsibility in policy-making.
• Exploration of macro- to micro-level factors influencing health and disease in the workplace.

Main Results:

• A purely biomedical view of causality in occupational health can be myopic, neglecting crucial economic and political factors.
• Effective prevention requires governance to establish policies based on comprehensive evidence and to acknowledge responsibilities.
• Participatory policy-making processes can be lengthy and may not adequately address the needs of vulnerable populations.

Conclusions:

• A "glasses for science" is needed to provide macro- to micro-level evidence linking health determinants to disease.
• A "hearing aid for politics" is essential for governance to responsibly implement preventive measures, prioritizing vulnerable individuals.
• Integrating scientific evidence with political responsibility is crucial for promoting long and healthy lives in the context of occupational health.