Chronic hazards and acute enforcement: dilemma for occupational health enforcement policy.

It is a well-understood principle of public health--and of disease control in general--that preventive efforts must be consistent with the natural history of a targeted disease. Governmental standards-setting and enforcement policies in occupational health confuse short-term strategies for safety hazard control with long-term disease control. Recent decisions in mining to rely on "significant and substantial" acute risk are incompatible with medical and epidemiological evidence on the nature and progress of chronic disease in many industries.