McCunney R J, Cikins W
Boston University Medical Center, MA.
Pol J Occup Med. 1990;3(3):241-56.
All three branches of the federal government affect occupational medicine. Notable examples include: 1) the Department of Transportation ruling (1988) requiring drug testing in diverse areas of the transportation industry (executive branch); 2) the Workplace Drug Act (1988) calling for organizations to have a policy towards drug and alcohol abuse (legislative branch); and 3) the Supreme Court ruling on the constitutionality of drug testing in the transportation industry (1989) and that infectious diseases are a handicap in accordance with the 1973 Federal Rehabilitation Act (1987). The executive branch plays a major role in occupational medicine primarily through the Occupational Safety and Health Administration (OSHA), which issues standards based on a rule making process; the executive branch can also affect occupational medicine indirectly, as evidenced by President Reagan's Executive Order 12291 calling for Office of Management and Budget oversight of regulatory initiatives. The legislative branch enacts laws, conducts hearings, and requests reports on the operations of federal agencies. The judicial branch addresses occupational health issues when people affected by an executive ruling want to challenge the ruling; or in the case of the Supreme Court, when deliberating an issue over which two circuit courts of appeal have come to divergent opinions. The Occupational Medicine profession can participate in the political process through awareness of proposed legislation and by responding accordingly with letters, resolutions, or testimony. Similar options exist within the executive branch by participating in the rule-making process. A representative of the Governmental Affairs Committee, through periodic visits with key Washington representatives, can keep members of the American College of Occupational Medicine informed about federal legislative and regulatory activities. In appropriate cases, the organization can then take a formal position on governmental activities that affect the speciality.
联邦政府的三个部门都对职业医学产生影响。显著的例子包括：1）运输部的规定（1988年），要求在运输行业的不同领域进行药物检测（行政部门）；2）《工作场所药物法案》（1988年），要求各组织制定针对药物和酒精滥用的政策（立法部门）；3）最高法院关于运输行业药物检测合宪性的裁决（1989年），以及根据1973年《联邦康复法案》（1987年）认定传染病属于残疾的裁决。行政部门在职业医学中主要通过职业安全与健康管理局（OSHA）发挥重要作用，该局通过规则制定程序发布标准；行政部门也能间接影响职业医学，里根总统的第12291号行政命令要求管理和预算办公室对监管举措进行监督就是证明。立法部门制定法律、举行听证会并要求提交有关联邦机构运作的报告。当受行政裁决影响的人想要对该裁决提出质疑时，司法部门会处理职业健康问题；或者在最高法院的情况下，当审议两个上诉巡回法院意见分歧的问题时。职业医学专业可以通过了解拟议的立法并相应地以信件、决议或证词做出回应来参与政治进程。通过参与规则制定程序，在行政部门也有类似的选择。政府事务委员会的一名代表通过定期拜访华盛顿的关键代表，可以让美国职业医学学院的成员了解联邦立法和监管活动。在适当情况下，该组织随后可以就影响该专业的政府活动采取正式立场。
