Commentary: Industry can damage your healthBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7077.342 (Published 01 February 1997) Cite this as: BMJ 1997;314:342
- Paul Garner, head of the international health divisiona
Poverty causes disease, and specialists view economic growth as central to good health in poor countries.1 Industry is a mainstay of development, yet converting labour from a social property to an adjunct of capital has adverse consequences.2 The lasting image of Bhopal, the cloud of poisonous gas from a multinational company that left thousands of people dead and many more injured, should remind us all that industry can kill and maim the very groups that development is supposed to benefit. We are still discovering long term injury from that event in Bhopal 12 years ago.
Industrial risk in poor countries is vast: exposure ranges from dangerous glues used to make shoes in shanty huts to unsafe steel smelting plants.3 Bhopal was an extreme example, but every day in developing countries there are a wide range of industrial accidents in the workplace, and people are poisoned over many years by industrial pollution.4 Yet sometimes those in authority play down these risks: in the occupational health section of the World Development Report the World Bank starts with deficient household water and sanitation for women who work at home, move to agriculture, and end without once mentioning the word industry.1 In contrast, the World Health Organisation points out that in most developing countries there are no effective legal or institutional structures to deal with pollution in the workplace and surrounding areas.3 The chasm in this area of public health is frightening, particularly as exposure will become more intense as industry develops and more of the world's poor come to live in cities.5
Much could be done in developing countries immediately to reduce occupational and local environmental risks from industry without awaiting further research. Studies that simply describe the extent of industry related exposure to harmful agents in developing countries assist advocacy for effective legislation. Cullinan et al show how much valuable epidemiological information can be generated with limited resources. Unfortunately, few studies have been reported. Medline (1991-5) lists only three articles about diseases related to Bhopal, in a total of 269 exposed people; whereas there are eight big studies on Sellafield (United Kingdom), one of which follows over 75 000 people.
Industry invests in science to maximise profit, but there should be an equal investment to protect the public, wherever they live. The injustice is worse when the profiting elite do not even live in the country that their industry is damaging. Any organisation promoting or participating in economic development in poor countries has a moral responsibility to ensure they do not risk the health of the majority for the benefit of a few.