Why use genetic tests?

Genetic testing is used in various ways. Genetic screening examines the genetic makeup of employees or job applicants for specific inherited characteristics. It may be used to detect general heritable conditions that are not associated with workplace exposures in employees or applicants.

Genetic screening can also be used to detect the presence of genetically determined traits that render an employee susceptible, or hypersusceptible, to a certain disease if exposed to specific environmental factors or substances that may be present in the workplace. In theory, genetic screening for occupationally relevant traits has the potential to be used to assign employees who are genetically susceptible to certain occupational diseases away from harmful exposure. However, no consensus currently exists regarding the validity of the scientific evidence or the usefulness of the genetic tests reported to predict an individual's susceptibility to exposure.

Genetic monitoring ascertains whether an individual's genetic material has changed over time due to workplace exposure to hazardous substances. Evidence of genetic changes in a population of workers could be used to target work areas for increased safety and health precautions and to indicate a need to lower exposure levels for a group exposed to a previously unknown hazard. The ultimate goal of genetic monitoring is to prevent or reduce the risk of disease caused by genetic damage.

Although genetic changes such as chromosomal damage have been associated with exposure to radiation and some chemical mutagens or carcinogens, little is known about which changes are predictive of subsequent disease risk.

Risk of discrimination. Some employers may seek to use genetic tests to discriminate against workers-even those who have not yet or who may never show signs of disease-because the employers fear the cost consequences. Based on genetic information, employers may try to avoid hiring workers who they believe are likely to take sick leave, resign, or retire early for health reasons (creating extra costs in recruiting and training new staff), file for workers' compensation, or use health care benefits excessively.

Federal legislation. This fear of employer misuse of genetic information has led to the enactment of federal legislation that restricts an employer’s acquisition and use of individuals’ genetic information. Designed to encourage Americans to take advantage of genetic testing without fear of discrimination, the Genetic Information Nondiscrimination Act of 2008 prohibits employers from using individuals' genetic information when making hiring, firing, job placement or promotion decisions. It also makes it illegal for group health plans and health insurers to deny coverage to healthy individuals or charge them higher premiums based solely on a genetic predisposition to a disease. For more on prohibited employment practices under GINA, see ¶70,770 .

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), prevents insurers from using genetic information to establish a preexisting condition and, thus, deny or limit coverage.