Employees in the civil service want general health screening to be a priority for occupational health services, while their personnel managers see pre-employment medical examination as the most important function of the chief medical officer.

The results of the first survey of the perceived health needs of civil service employees were presented to an International Occupational Health Conference in Dublin yesterday. The study, by Dr John Malone and Dr Alex Reid, sought the views of a representative sample of 3 per cent of the State's 28,000 employees. All 34 personnel officers in the civil service were also invited to participate.

Commenting on the results, Dr Reid said they represented a challenge to the future direction of the service. "I believe that this information can be positively used in the development of our service," he told delegates.

Dr Robert Goldberg, past president of the American College of Occupational and Environmental Medicine, spoke of the impact of genomics on the health of workers. While many new developments in the human genome project can be positively applied in occupational medicine, he warned that there were many legal, ethical and social issues which must be addressed.

Using the example of a genetic test to identify workers in industry who are likely to develop liver cancer if exposed to vinyl chloride, he said the use of such a test raised issues of confidentiality, whether such tests should be optional or mandatory for employees and the legal implications of introducing a genetic screening test in the workplace.

According to the World Health Organisation regional adviser for healthy workplaces, there are a number of forces which drive an enterprise to implement good practice in occupational safety: national regulatory frameworks; effective management systems in which health and safety issues have been integrated into a company's development plan, and the existence of voluntary agreements relating to health and the environment which have a positive impact on the wider community.

Dr Boguslaw Baranski told the meeting that health promotion, as a process which enables people to increase control over their health, must be central to all health and safety interactions with individual workers. Dr Noel McElearney, director for group health, safety and environment at Scottish and Newcastle plc in Britain, told the meeting there were an estimated two million people in the UK with an occupational illness.

Some 750,000 of these are caused by work-related stress, which is a significant and expensive problem for both industry and the health service, he said. Dr McElearney defined stress as something felt when a person cannot cope. He questioned the modern management tendency to take people from a comfort zone to a "stretch zone" without allowing them the opportunity to return at regular intervals.