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PubMed1999

[A quality assessment of notified occupational diseases submitted to the National Occupational Environment Service].

The aim of this study was to assess the quality of a consecutive sample of occupational disease notifications submitted to the National Working Environment Service during 1994. The sample consisted of 860 notifications describing occupational diseases among persons working in companies situated in the county of Vejle. The data information e.g. company name and address, time of employment, harmful exposure and disease, were registered. An overall data quality assessment was performed including evaluation of the etiological connection between described occupational exposure and disease and potential preventive perspectives. The study showed that the notified informations in general were adequate, but doctors need to pay more attention to dose description of the harmful exposure. About 80% of the notifications presented an adequate connection between occupational exposure and disease. Only half of the notifications described preventable and recent (less than five years) harmful exposure. In conclusion, the Danish occupational disease notification system is in general of a high standard, and the National Working Environment Service could make more use of doctors' information provided in these notifications.

Cross-Sectional Studies↗
PubMed1986

[Principles of decisional analysis applied to the screening for occupational diseases: the example of occupational fluorosis].

In this paper, two oral presentations are combined. The first described the broad aspects of decision analysis and the second mentioned those medical data which need to be gathered in order to apply the model to industrial fluorosis. For this purpose, biological and medical observations were collected, both from workers of the aluminium industry and from controls. The five successive steps for building up a decision tree are then demonstrated, the aim of which being to evaluate the fitness of a screening strategy. A computer programme has been developed which may be applied both to occupational or non occupational diseases. Referring to industrial fluorosis, the computerized decision tree showed that screening with preshift urinary fluor, clinical and radiological signs, plus bone fluor rate is required, as soon as the risk corresponds to a 7% prevalence of the disease.

Aluminum↗
PubMed2005

Work-related infectious disease reported to the Occupational Disease Intelligence Network and The Health and Occupation Reporting network in the UK (2000-2003).

BACKGROUND: Infectious diseases remain an important cause of self-reported work-related illness, with socio-economic consequences, including sickness absence. Reporting of infectious disease by occupational and specialist physicians is an important tool in the investigation of occupationally related infections and is relevant in their management. AIMS: To examine the reporting of cases of infectious disease by occupational and specialist physicians to schemes collecting data on occupational ill-health. METHODS: Cases of infectious disease reported by occupational and specialist physicians to the UK based schemes, Occupational Disease Intelligence Network (ODIN) and The Health and Occupation Reporting network (THOR), from 2000 to 2003 were analysed by reporting patterns, diagnosis, single case or outbreak reporting and industry. RESULTS: The total number of estimated cases of infectious disease reported to ODIN and THOR from 2000 to 2003 was 5606; 74.9% cases were diarrhoeal disease, and 11.1% scabies. The majority (81.4%) of cases were reported in SIDAW, where the participation rate for reporters was 55%. Reporting rates were much higher in OPRA, SWORD and EPIDERM (ranging from 86 to 96%). The most frequently reported industrial sectors were social care (39.5%) and health (29.4%); while the manufacture of chemical products contributed 4.3% overall, but 33.8% to estimated cases in OPRA. CONCLUSIONS: Despite limitations related to under reporting, the occupational and specialist physician schemes in ODIN and THOR provide data that may be used to look at patterns of case reporting for occupational ill-health, including infectious disease. The reporting schemes also provide an important means of alerting peers about potential novel causes, precipitating factors, or industrial sectors associated with occupational disease.

Communicable Diseases↗
PubMedDate not supplied

[The diagnosis of occupational diseases: a specific task of occupational doctors].

The Authors examine the problem dealing with Occupational disease diagnosis focusing five main points: diseases of probable/possible occupational origin; chronic and acute diseases; diseases due to biological agents; presumptive causation in legal compensation; public health statistics and medical reports. They conclude that new rules are needed and more advice from Occupational Medicine is required.

Accidents, Occupational↗
PubMedDate not supplied

Ethical issues in occupational disease outbreak investigations.

Occupational disease outbreak investigations usually involve rapid, small-scale analysis of reports of diseases with a suspected occupational etiology, usually in a single workplace or among workers of a single employer. Ethical issues are similar to those encountered in epidemiologic studies in the workplace, with the added constraints of the need to respond rapidly, limited numbers of subjects, low statistical power, and the mandate to issue results even when the ability to generalize them is limited. Informed consent, voluntary participation, fairness, and confidentiality are major ethical issues in workplace outbreak investigations. The obligation to publicly report a workplace hazard when a non-disclosure statement has been signed can also present an ethical dilemma for outbreak investigators.

Communicable Diseases↗
PubMed2000

[Reasons for difficulties encountered in diagnosing and certifying occupational disease reported by some regional centers of occupational medicine].

Observations about kinds of and reasons for difficulties encountered in diagnosing and certifying occupational diseases, made during the analysis of over 3,000 medical history files, were verified with the opinions of the personnel employed in the 14 selected regional centres of occupational medicine. The evaluation of the body of workers, the diagnostic basis, kinds of diagnostic and certification difficulties and their causes, the data on diagnosed occupational diseases, and appeals against certifications which negate the grounds for diagnosing occupational diseases were surveyed and the results presented. The results obtained indicate convergent causes of incorrect decisions taken by those involved in the Institute, and by directors of regional centres of occupational medicine. This provides the basis for developing measures aimed at eliminating the mistakes made in the process of diagnosing and certifying occupational diseases.

Certification↗
PubMed1990

Role of medical screening in the prevention of occupational disease.

Some occupational medical screening programs are designed to detect adverse health effects of workplace hazards and to complement environmental control programs. Often, programs are developed using the approach of clinical practice, and procedures are not adequately standardized. The logic that guides this decision making is not well developed, thus limiting the ability of occupational health practitioners to make defensible decisions regarding the management of individual workers at risk. Although the programs are, in theory, constructed to benefit the worker, little thought has been given to standardization of data collection and to using the medical information that is obtained. Currently, the National Institute for Occupational Safety and Health (NIOSH) is developing recommendations to present to the Occupational Safety and Health Administration to be used in the development of a "generic approach" to screening. These recommendations will include guidelines for threshold exposure levels for screening, rosters of screenable health effects to be targeted, algorithms linking exposure and effects, criteria for test result evaluation, plans for courses of action after testing, and procedures to ensure confidentiality. NIOSH's comprehensive approach to developing occupational screening programs should benefit employees, employers, the scientific community, and the community at large.

Humans↗