It seems like an innocent request from a prospective employer, for example– "The job is yours, all we need is for you to have a medical examination." Maybe you rarely drink, have never taken illegal drugs, and are in pretty good health, you allow a blood sample to be taken, knowing you have nothing to hide.

But do you know exactly what your employer may be testing for? Maybe they’re only testing for controlled or illegal substances. Or maybe they’re testing for the genes linked to certain diseases, such as cancer, hoping to avoid costly medical bills down the road.

Pre-employment medical testing has been around for years. Genetic testing is just beginning to emerge. As the cost of genetic tests decrease, and more sophisticated testing becomes available, more employers will be expected to use the technology in their selection process, according to Eric Greenberg, Director of Management Studies for the American Management Association (AMA).

The AMA estimates 77 percent of employers require medical testing, which could include blood and urine tests, and less than one percent require genetic testing, which is usually done through blood tests.

As a result of the federal government's human genome project, a 15-year project to catalog and understand the 80,000 to 100,000 genes in the human body, it is now possible to identify individuals who are at increased risk of developing Alzheimer's disease, heart disease, breast cancer, cystic fibrosis, and many other debilitating illnesses.

Critics of genetic testing in the workplace say it can lead to discrimination in hiring, promotions, and insurance coverage, even though the tests are not 100 percent reliable.

"There will always be vendors of genetic testing that will try to sell their products based on how it can save [health care and insurance] costs to employers," said Greenberg. "If employers buy into this there is a potential for abuse."

The threat of abuse was enough for the AMA to offer the following advice to its members as part of its annual survey Workplace Testing and Monitoring. "Employees and job applicants who are subject to genetic testing should be fully informed of its purpose," the survey said. "They should know in specific detail what the tests are intended to find and the effects of positive results on their employment status. They should be informed of their test results in clear language."

Paula D. Pearlman, Supervising Attorney for the California Women’s Law Center has her own hard and fast rule about genetic testing in the workplace. "I would never recommend that a [job] applicant submit to genetic testing for employment," she said. "I wouldn’t do it, but I’m very guarded about my privacy. It’s a choice people have to make by balancing the need for the job and their need for privacy."

With more emphasis being placed on reducing medical and insurance costs, Pearlman fears employers will begin using genetic testing to screen potential female employees for mutations in the BRCA1 and BRCA2 genes, which have been linked to a higher risk of breast and ovarian cancer.

Although such cases of discrimination haven’t been seen by her organization, which deals specifically with legal issues surrounding breast cancer, Pearlman said job applicants generally are not looking for signs of potential discrimination.

"Most of the companies that do genetic testing are large companies. We have a sense these people won’t hurt us," Pearlman said. "We walk in with a high level of trust."

Instead, applicants should go into job interviews knowing their rights and be prepared to ask non-threatening questions regarding both medical and genetic tests: Do you test everyone? Who sees the results? What’s done with the results after the interview?

Job applicants should be cautious about the more common medical tests, as well. For instance, they should be aware federal law prohibits employers from requiring a pre-employment medical exam until a job offer has been made.

Despite the potential for abuse, Greenberg defends employers' use of various types of pre- employment testing. "Employers do have a legitimate interest in gauging a person’s ability to do the job," he said.

American Management Association