Beyond the duality of disease and illness in occupational medicine

This article addresses how changes in occupational morbidity are demanding new research approaches to provide relevant contributions for workers’ protection and the improvement of workers’ health standards in contemporary society. This is a necessary and timely reflection considering that at the turn of a new century, occupational diseases and injuries still represent a relevant health burden in most countries, challenging researchers and policy makers for more appropriate studies and effective actions. In this issue, Coggon¹ points to: (1) the fact that current prevailing occupational diseases are musculoskeletal disorders and occupational stress; (2) their distinct relation to work risks, unclear ties between disease and illness expressions, and evidence of association with emotional factors; and hypothesises that they are not diseases (a biomedical concept based on objectively recognisable abnormalities), but illnesses (a subjective state of discomfort and suffering), a distinction proposed by Field (1976)² and Susser (1973).³ Most controversial is the author’s statement that these occupational diseases are resulting from …