The Unexpected Result of an Investigation of an Outbreak of Occupational Lung Disease

Abstract

The author describes the discovery of a cluster of cases of interstitial lung disease among employees of a textile manufacturing plant and the difficulties he and his university-hospital occupational medicine team encountered in attempting to identify the cause of the disease. At first accepted in a consultant capacity by the plant's management, the team met increasing resistance to its efforts as it uncovered evidence of a work-related cause of the disease and attempted to communicate its findings to both the workers and their union. Ultimately the plant's management dismissed the occupational medicine team and threatened legal action if it published or presented its scientific findings. Both hospital and university administrators attempted to thwart the team's efforts to publish their findings and colluded in summarily terminating the occupational medicine program. The author emphasizes the points actually at issue: the need to protect the freedom of scientists to communicate findings important to the health of the public, and the physician's overarching professional responsibility to his or her patients.

Keywords:

• public health
• occupational disease
• interstitial lung disease
• conflicts of interest
• ethics
• professional responsibility
• textile industry