Loaded Professional Practices: the clinical examination of workers by occupational health services

Since 1946, industrial medical services (and later, "occupational health services") have been directed, organized and financed by employers and their representatives. Many doctors try to make the best of this situation, yet express a vague but indisputable unease. A qualitative study of occupational health doctors and workers shows that occupational health practices, both past and present, ultimately do not result in a coherent ensemble of actions toward stated goals (these being worker health protection and the adaptation of work to man). Rather, such practices fall into an institutional framework that prioritizes preliminary medical screening over intervention in workplace environmental conditions. Analyzing interviews with workers and with occupational health doctors enables us to understand the scope and limits of occupational health practices, which seek legitimacy as well as coherent solutions.