Diagnostic ecologies: Medical standards, tinkering, and worker health in Turkey

In Turkey's occupational health system, doctors must use the International Labor Organization's (ILO) standards to classify the chest radiographs of workers at risk of lung diseases caused by dust exposure. Yet these standards do not provide a uniformity of care within the tripartite structure of the occupational health system, which divides disease surveillance, disease diagnosis, and worker compensation into distinct silos. This division often produces ambiguity and unpredictable outcomes for occupational disease claims. The traffic of diagnostic decisions among workplaces and medico-legal institutions-what I refer to as diagnostic ecologies-shapes medical knowledge. The tripartite organization of the occupational health system in Turkey makes the evaluation of chest radiographs a space where professional expertise and professional ethics are constantly negotiated. A focus on diagnostic ecologies illustrates how disease ontology is distributed across the occupational health system's components.