title: Discriminatory aspects of pre-employment screening: low-back X-ray examinations in the railroad industry.
abstract: In screening the majority of job applicants, most of this nation's railroads administer a low-back X-ray examination in an attempt to ascertain the likelihood that the applicant will sustain future work-related low-back pain or injury. Many applicants are rejected for employment on the basis of the X-ray findings. The railroads apparently perceive this screening program as a cost-effective means (1) of decreasing the incidence of compensation claims for work-related injuries, brought against the railroads under the Federal Employers' Liability Act (FELA), (2) of reducing the number of lost workdays resulting from low-back pain or injury, and (3) of protecting particularly susceptible workers from job-related hazards. The authors of this Article submit that low-back X-ray examinations are poor predictors of future low-back pain or injury. They assert that the railroads' use of such examinations misclassifies a substantial number of job applicants as being at increased risk for such pain or injury, and, in consequence, unfairly denies them employment. Furthermore, the authors claim, the screening program has other negative consequences. For example, applicants rejected for railroad employment on the basis of X-ray findings may as a result have difficulty finding jobs in other industries. In addition, they state, there is a potential radiation hazard to examinees. Moreover, both the railroads and those applicants accepted for employment may inappropriately be reassured by normal findings. On balance, the authors conclude, the screening program has a negative social value. The authors suggest that the program, in effect, erraneously labels many applicants as handicapped, and then denies them employment. Such persons might have legal recourse under federal and state statutes prohibiting employment discrimination against the handicapped.
mesh_terms: D001416:Back Pain / Q000175:diagnosis / Q000000981:diagnostic imaging; D004185:Disability Evaluation; D004651:Employment; D006801:Humans; D007878:Legislation as Topic; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D009787:Occupational Medicine; D011287:Prejudice; D011859:Radiography; D011890:Railroads; D014481:United States