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The World Health Organization, aka the W.H.O, recently decreed to great fanfare that new diseases no longer should be given a name linked to any person, place, or human activity. The stated rationale was the need to avoid stigma, but sub rosa, this was as much about financial sensitivity as it was consideration of potential victims.
The W.H.O cloaked its argument in the trappings of human rights, arguing that old-fashioned disease naming could serve to promote backlash against members of religious or ethnic communities. It’s not easy to come up with a clear-cut modern example of that, for example rampant prejudice associated with referring to monosodium glutamate-caused illness as “Chinese Restaurant Syndrome,” but on theoretical grounds, at least, a specific naming proscription of this sort seems reasonable. The W.H.O. went far beyond that, however. One telling example cited by Dr Keiji Fukuda, the W.H.O Assistant Director-General for Health Security and spokesperson for the new policy, was the downside of calling influenza originating in pigs “swine flu.” Obviously the swine don’t feel any stigma. That’s not the point: the wrong name might, in the W.H.O’s assessment “…trigger needless slaughtering of food animals. This can have serious consequences for peoples’ lives and livelihoods” (http://www.who.int/mediacentre/news/notes/2015/naming-new-diseases/en/).
In addition to the potentially misguided animal slaughter, Dr. Fukuda also highlighted barriers that a wrongly named disease might give rise to. A case in point is “commerce and trade,” with the W.H.O. explicitly labeling verboten any “industry or occupational references (e.g. legionnaires).” There is a certain unintended irony in the chosen example. The designation Legionnaire’s Disease specifically leaves out mention of Philadelphia’s Bellevue-Stratford Hotel, whose ventilation system was ultimately implicated in the original outbreak of that disease. More than that, being in the American Legion may be an avocation, but that hardly makes it an occupation. What the W.H.O actually would have us omit is the coal worker in coal worker’s pneumoconiosis (progressive scaring of the lung from coal dust, although presumably “black lung” would be o.k. by the W.H.O.) and the welder in welder’s flash (that is, eye inflammation from ultraviolet light from welding; referring to “snow blind” also might be a sensitive issue to ski manufacturers too, based on WHO criteria).
Giving names to conditions in recognition of the risk borne by workers does more to honor than stigmatize them. More than that, it can be critical in raising public awareness, particularly among consumers who might otherwise not see the link between what they purchase and who became ill making the product, or installing it, or disposing of the waste later on. The W.H.O. might be a little more interested in the needless slaughter of workers as opposed to livestock.
Popcorn worker’s lung, a no-no in the new W.H.O guidelines, made the public take notice that something was amiss in the lungs of those exposed in a way that the name “artificial butter-flavoring associated disease of the airways” would have been unlikely to have gotten across. Needless to say, the popcorn manufacturers might have been happier with an alternative moniker. I experienced something along these lines when I co-authored with colleagues a medical report on a devastating outbreak of silica-caused lung disease in workers who installed high-end kitchen and bathroom counter tops. We had the audacity include in the medical article’s title “Caesarstone Silicosis.” After it was accepted for publication, the journal removed the product name (http://www.ncbi.nlm.nih.gov/pubmed/22383661).
There is a long tradition of linking medical conditions to occupations. Some of these associations are no doubt obscure to modern practitioners, for example, wool sorter’s disease (anthrax infection that once was lethal to British workers in the trade) or the hatter’s shakes (endemic mercury poisoning in felt hat workers), but the tale these names tell should not be forgotten. Other occupational disease names simply seem arcane today, such as telegrapher’s cramp, even though we might have done well to pay more attention to that precursor of what would later be known as carpal tunnel syndrome. Carpal tunnel syndrome, in turn, is just one member of a modern family of “cumulative trauma disorders” brought on my any number jobs. There are so many that at least one online resource provides a list of job titles that may be at risk, including “Pin-Game-Machine Inspector” (that is, someone who inspects and repairs pinball and games machines). Which brings us back, at least, to the WHO if not the World Health Organization.
