Samuels S W
The Ramazzini Institute, Solomons Island, MD 20688, USA.
Int J Health Serv. 1998;28(1):153-64. doi: 10.2190/44MR-YPQF-KUKP-NPQY.
The caste in which workers and occupational health practitioners find themselves is plagued by intertwined but separable conflicts. A Cartesian model of causation, useful in the demonologies of regulation and toxic torts, is not heuristic in the revisions of health care, worker's compensation, and disability systems, nor in the prevention of violence in the workplace. Outside the caste, science progresses beyond mind-body bifurcations, the adverse effects of which are magnified within the caste. An argument is made for an ecological concept of causation, drawn from Darwin's community approach to the web of causal factors in both cultural and biological evolution, subsequently stimulated and developed by G. H. Mead and by biologically oriented and sociologically oriented human ecologists for application in the workplace. The ecological model is found in occupational biomedicine as practiced by leaders as diverse as Tichauer and Selikoff. The model integrates environmental, lifestyle, and genetic vectors in a community system bonded by communication and embracing a view of work unbifurcated from other activities.
工人和职业健康从业者所处的阶层深受相互交织但又可分离的冲突困扰。笛卡尔因果模型在监管和有毒侵权的魔怪学中有用，但在医疗保健、工人赔偿和残疾系统的修订中，以及在预防工作场所暴力方面并无启发性。在这个阶层之外，科学超越了身心二分法，而在该阶层内，身心二分法的不利影响被放大。本文提出了一种因果关系的生态概念，它源自达尔文对文化和生物进化中因果因素网络的群落研究方法，随后由G. H. 米德以及生物导向和社会导向的人类生态学家加以推动和发展，以应用于工作场所。生态模型可见于蒂乔尔和塞利科夫等不同领域领导者所践行的职业生物医学中。该模型将环境、生活方式和遗传因素整合到一个通过交流联系在一起的群落系统中，并包含一种工作与其他活动不分叉的观点。
