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Causal values.

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C Poole. 2001. Causal values.. https://doi.org/10.1097/00001648-200103000-00001

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Mortality from obstructive lung diseases and exposure to polycyclic aromatic hydrocarbons among asphalt workers.

Work in the asphalt industry has been associated with nonmalignant respiratory morbidity and mortality, but the evidence is not consistent. A historical cohort of asphalt workers included 58,862 men (911,209 person-years) first employed between 1913 and 1999 in companies applying and mixing asphalt in Denmark, Finland, France, Germany, Israel, the Netherlands, and Norway. The relations between mortality from nonmalignant respiratory diseases (including the obstructive lung diseases: chronic bronchitis, emphysema, and asthma) and specific chemical agents and mixtures were evaluated using a study-specific exposure matrix. Mortality from obstructive lung diseases was associated with the estimated cumulative and average exposures to polycyclic aromatic hydrocarbons and coal tar (p values of the test for linear trend = 0.06 and 0.01, respectively). The positive association between bitumen fume exposure and mortality from obstructive lung diseases was weak and not statistically significant; confounding by simultaneous exposure to coal tar could not be excluded. The authors lacked data on smoking and full occupational histories. In conclusion, exposures to polycyclic aromatic hydrocarbons, originating from coal tar and possibly from bitumen fume, may have contributed to mortality from obstructive lung diseases among asphalt workers, but confounding and bias cannot be ruled out as an explanation for the observed associations.

Causality↗

[Medical expert assessment, objectivity and justice in disability pension cases. ].

BACKGROUND: The formal principle of justice is often interpreted as the requirement of objectivity when a person's situation is to be evaluated in the light of social justice. The aim of this article is to analyse whether or not the formal principle of justice is fulfilled by the ontological and the epistemological concept of objectivity when disability claims are evaluated medically in relation to the Norwegian legislation on disability benefits. MATERIAL AND METHODS: material is legal and medical texts about medical disability evaluation. The method is text analysis. RESULTS: The main result is that the concept of ontological objectivity functions as the criterion of objectivity when the causal relations between sickness, impairment and disability are explained. This criterion is, however, problematic because it is based on the assumption that there is a linear causal model of these relations, which precludes the explanation of many cases of disability. INTERPRETATION: The ontological concept of objectivity is not a necessary condition for impartiality and formal justice in relation to the causal relation between sickness and disability. In some situations this concept is a sufficient condition. The epistemological concept of objectivity is a sufficient condition, but it is not a necessary condition. Some cases must be reviewed on a discretionary basis.

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