Critical ethical issues in biomonitoring for occupational health risk assessment

If a society aims at preserving its socio-ethical values, practices in occupational health surveillance and research may not conflict with these values. The Universal Declaration of Human Rights, ILO Convention 161 and the ICOH Code of Ethics for Occupational Health Professionals are key references for values to be respected in  occupational healh practices. In line with these, practices must aim at protecting both health and employment of every candidate or employee. For assessing ethical acceptability of occupational health surveillance practices in general and biomonitoring practices in particular, their accuracy, relevance, need or necessity and consequences must first be analysed. This analysis must constitute the basis for a societal democratic decision making process on their socio-ethical acceptability. This decision making process can eventually be complemented but never substituted for by individual informed consent, because of the real or perceived power inequality. A physician trained in occupational health is the professionalism required for doing the testing and assuring the protection of the confidentiality of medical data, in accordance with strict legal and deontological rules. The above conditions are necessary for creating employees’ trust in his unequivocal mission.   In contrast, informed consent should be given much weight in research settings. This may considerably contribute to the committment of study subjects with the goals of publically funded impartial research in ocupational health and to promote such research. Ethical and legal requirements should be the same for any research in this domain, and thus also for research conducted at the sole initiative of interested companies.