Psychological and social factors are important in explaining symptoms in conditions such as Sick Building Syndrome, a conference on occupational health was told at the weekend.
Dr Anne Spurgeon, senior lecturer at the Institute of Occupational Health, University of Birmingham, told the annual general meeting of the Irish Society of Occupational Medicine there was a need to look beyond a worker's physical exposure in certain disorders where a defined pathological process did not exist.
She suggested a common psycho-social link between conditions such as work-related upper limb disorder, Gulf War syndrome and a farmers' disease linked to low-level organophosphate exposure from sheep-dipping.
Warning of the futility of a sterile debate on physical versus psychological causes for these conditions, she told doctors there was a need to integrate both factors on a case-by-case basis.
Often what determined whether symptoms were experienced was a perceptual process of "selective internal attention", she said. This heightened attention to internal changes was more likely to occur when people were working in a tedious, un-stimulating environment. External factors such as an increased concern about risk also contributed to the experience of symptoms.
Dr Spurgeon spoke in detail about "sheep-dip disease" in farmers, a syndrome linked to chronic exposure to organophosphate chemicals. Farmers have reported extensive tiredness and neurological symptoms following exposure.
While accepting there was a low-level exposure to a hazardous chemical, she suggested that factors such as a farmer's isolation, economic stress and a prevailing "anti-chemical" culture were important in determining which farmers became ill.
"I am not saying the syndrome is all in the mind. It is an interaction between the mind and the body, and I am suggesting we accept that the symptoms are a product of this interaction", she said.
Ms Patricia Murray, an occupational psychologist with the Health and Safety Authority (HSA), described a workplace stress initiative, Work Positive. Due for launch in January 2002, it is aimed at prioritising stress at an organisational rather than an individual level.
The programme is currently devising a risk-assessment tool in 16 companies in the Republic and Scotland, which can be administered in-house. She emphasised that Work Positive would not measure stress but be designed to locate the source of it within companies.