by Allard E. Dembe, 344 pp, with illus, $37.50, ISBN 0-300-06436-5, New Haven, Conn, Yale University Press, 1996
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It is Allard Dembe's contention that physicians are influenced by a wide variety of social factors in considering certain conditions to be occupational diseases. Based on his review of research and available empirical data, Professor Dembe has identified 12 factors that are particularly relevant to understanding how occupational disorders are initially recognized and conceived: new technologies, legal determinants of financial compensation, labor activism, economic instability, public reactions, cultural stereotyping, medical specialization, mass media attention, profit motive of vendors selling prevention and treatment devices, military conflict consequences, political benefit from supporting control of health problems, and high costs for control technology reducing the likelihood of medical recognition of a problem, as there is little chance of amelioration.
One of the author's primary objectives is to characterize these factors, describing their complexity and interrelationships as they apply to particular disorders. To make his point, Dembe selects three controversial work-related disorders: cumulative trauma
DeHart RL. Occupation and Disease: How Social Factors Affect the Conception of Work-Related Disorders. JAMA. 1997;277(1):84-85. doi:10.1001/jama.1997.03540250092048