Genetic tests to be used more

Genetic testing for employment purposes is not yet being used systematically but it is likely to be increasingly used as science and technology advance. However, it should only be used in very restricted circumstances, according to a report published last week by Britain's Human Genetics Advisory Commission (HGAC).

The commission recommends that genetic testing in employment should not be banned but it should only be used in limited circumstances, such as to detect conditions that could put the employee or others at risk in the workplace. It could also be used to determine if an employee might be more susceptible to certain features of specific jobs or working environments "that do not normally present any hazard". The report says: "Our conclusion therefore is that it would not be in anyone's best interests to ban the use of genetic test results for employment purposes completely."

The commission recommends that genetic testing should not be used to gain information about a medical condition or a predisposition to a condition to establish likely levels of sickness absence from the workplace. Noting the potential for unfair discrimination, it says: "It would not be acceptable for genetic test results to be used to exclude people from employment or advancement on the grounds that they have a predisposition to future ill health".

The report, The Implications of Genetic Testing For Employment, "proposes a common set of policy principles to be observed should genetic testing in employment become a real possibility in the UK", says Baroness O'Neill, acting chair of the HGAC.

One principle laid down by the HGAC is that an individual should not be required to take a genetic test for employment purposes and an individual's "right not to know" the outcomes of genetic testing should be upheld.

A second principle is that an individual shouldn't be required to disclose the results of a previous genetic test unless the information is needed to assess "their current ability to perform a job safely or their susceptibility to harm from doing a certain job".

Thirdly, employers should offer a genetic test if it is known that a working environment or practice "might pose specific risks to individuals with particular genetic variations". If there is a danger to public safety, "an employer should be able to refuse to employ a person who refuses to take a relevant genetic test", says the report.

A fourth principle is that any employment-related genetic test must be accurate and reliable and reflect best practice. Any use of genetic testing should be "evidence-based and consensual" and results "should always be communicated to the person tested" and professional advice made available. Results of genetic testing must be treated in accordance with data protection laws, says the report.

Finally, if multiple tests are performed, each test must satisfy the principles already outlined.

The commission's Employment Working Group was set up to report on the "potential value of genetic testing in the workplace" and highlight consequent concerns; to raise awareness about the implications of genetic testing among employers and employees; and to "offer reassurance" that wider concerns about human genetics were being considered. The British Ministry of Defence already has a policy for testing all applicants for aircrew training for sickle cell carrier status. But the report says that this is the only instance in Britain where employers currently use genetic test results.

According to Dr Dan Murphy, director of occupational medical services at the Health and Safety Authority in Dublin, screening for sickle cell is the "only practical example which immediately comes to mind" of employment-related genetic testing. Possible sickle cell anaemia candidates need to be identified because high altitudes, with the consequent lowering of oxygen in the air that is breathed, could cause the "sickle cells to actually sickle" and the person would get a stroke.

He says a related issue is testing for atopy (a predisposition for asthma or dermatitis). "Is it valid to keep these people out of, say, a computer factory because they might get asthma? If you applied that, it means 30 per cent of the population couldn't work where there was a significant risk of exposure to an allergic substance. That's one out of every three people. It would be grossly unfair."

The Implications of Genetic Testing for Employment is available on the HGAC website: http://www.dti.gov.uk/hgac/