Diagnosing and Reporting of Occupational Diseases: An Assessment Study of Reports from an Italian Workplace Safety Prevention Program Service
Contenuto principale dell'articolo
Keywords
Abstract
Background: The criteria for diagnosing and compensating for occupational diseases vary significantly between countries. The lists of occupational diseases often include diagnostic and attribution criteria that are usually not very specific. As a result, the quality of occupational disease reports is frequently subpar. The aims of this study were to assess the quality of diagnosis and reporting, as well as to evaluate the causal link between reported occupational diseases and occupational risk factors. Methods: Four occupational physicians assessed the quality of diagnosis by blindly applying Spreeuwers’ performance indicators for diagnosis and reporting. Following Violante’s criteria, the four evaluators also tested the levels of evidence to evaluate the quality (and associated likelihood) of the diagnosis and the quality of exposure to occupational risk factors in a sample of 104 occupational disease reports, grouped by diagnosis and examined by the local Workplace Safety Prevention Service. Separate scores for each performance indicator and the Total Quality Score (TQS, ranging from 0 to 10), along with the progressive levels of evidence, were then assigned for each occupational disease report. Results: The mean TQS was below the threshold of sufficiency (<6) for 28% of the diagnoses, while an almost sufficient score (>6) emerged for 72% of the diagnoses, primarily including musculoskeletal disorders, pulmonary silicosis, and noise-induced occupational hearing loss. When applying Violante’s criteria for the level of evidence of the diagnosis, it was insufficient for 13.5% of the reported cases, while the level of evidence for exposure to occupational risk factors was deemed insufficient for 19% of the cases, and no cases demonstrated a level of evidence that was highly probable or nearly certain. Conclusions: Despite the overall quality of the reported cases of occupational diseases being reasonably good, improvements in the quality of diagnosis and reporting could be achieved through strict adherence to standardized diagnostic criteria and by training health personnel to collect data regarding occupational and non-occupational risk factors properly.
Riferimenti bibliografici
2. Ross DJ. Ten Years of the SWORD Project. Surveillance of Work-Related and Occupational Respiratory Disease. Clin. Exp. allergy J Br Soc Allergy Clin Immunol. 1999;29:750–753. Doi: 10.1046/j.1365-2222.1999.00557.x.
3. Cherry NM, Meyer JD, Holt DL, Chen Y, McDonald JC. Surveillance of Work-Related Diseases by Occupational Physicians in the UK: OPRA 1996-1999. Occup Med. (Lond). 2000;50:496–503. Doi: 10.1093/occmed/50.7.496
4. Esterhuizen TM, Hnizdo E, Rees D, et al. Occupational Respiratory Diseases in South Africa--Results from SORDSA, 1997-1999. S Afr Med J. 2001;91:502–508.
5. Karjalainen A, Aalto L, Jolanki R, Keskinen H, Makinen I, S.A. Occupational Diseases in Finland in 1999; Helsinki: Finnish Institute of Occupational Health, 2001;
6. Hauptverband der Gewerbliche Berufsgenossenschaften (HVBG) Geschafts- Und Rechnungsergebnisse Der Gewerblichen Berufsgenossenschaften. Sankt Augustin: Hauptverband Der Gewerblichen Berufsgenossenschaften; 2003.
7. Matte TD, Hoffman RE, Rosenman KD, Stanbury M. Surveillance of Occupational Asthma under the SENSOR Model. Chest 1990;98:173S-178S. Doi:10.1378/chest.98.5_supplement.173s.
8. Centre for Occupational and Environmental Health at the University of Manchester The Health and Occupation Reporting Network (THOR) Available online: http://www.medicine.manchester.ac.uk/coeh.
9. Bonneterre V, Bicout D, Bernardet C, Dupas D, de Clavière C, de Gaudemaris R. [The National Occupational illness surveillance and Prevention Network (RNV3P)and health monitoring]. Sante Publique. 2008; 20 Suppl 3:S201-10. Doi: 10.3917/spub.083.0201
10. Methodologies to Identify Work-Related Diseases: Review of Sentinel and Alert Approaches | Safety and Health at Work EU-OSHA.
11. Verbeek J. When Work Is Related to Disease, What Establishes Evidence for a Causal Relation? Saf. Health Work. 2012;3:110–116. Doi:10.5491/SHAW.2012.3.2.110
12. Commission of the European Communities Commission Recommendation of 19/09/2003 Concerning the European Schedule of Occupational Diseases. Report No.: C (2003) 3297; Brussels, 2003;
13. Blandin MC, Kieffer CLC. Occupational Diseases in 15 European Countries; Paris: Eurogip, 2002;
14. Blandin MC, Kieffer CLC. Survey on Under-Reporting of Occupational Diseases in Europe; Report no. Euro-gip-03/E.: Paris: Eurogip, 2002.
15. Coggon, D. Monitoring Trends in Occupational Illness. Occup Environ Med. 2001;58:691–693. Doi: 10.1136/oem.58.11.691
16. Azaroff LS, Levenstein C, Wegman DH. Occupational Injury and Illness Surveillance: Conceptual Filters Explain Underreporting. Am J Public Health. 2002;92:1421–1429, Doi: 10.2105/ajph.92.9.1421
17. Curti S, Sauni R, Spreeuwers D, et al. Interventions to Increase the Reporting of Occupational Diseases by Physicians. Cochrane database Syst. Rev. 2015:CD010305. Doi: 10.1002/14651858.CD010305.pub2
18. Porru S, Carta A, Toninelli E, Bozzola G, Arici C. Reducing the Underreporting of Lung Cancer Attributable to Occupation: Outcomes from a Hospital-Based Systematic Search in Northern Italy. Int Arch Occup Environ Health. 2016;89:981–989. Doi: 10.1007/s00420-016-1135-5
19. Campo G, Papale A, Baldasseroni A, et al. The Surveillance of Occupational Diseases in Italy: The MALPROF System. Occup Med. (Lond). 2015;65:632–637. Doi:10.1093/occmed/kqv167
20. Campo G, Leva A, Montanari P, Papale AG. di LM. MALPROF 2019-2020 - L’undicesimo Rapporto INAIL – Regioni Sulle Malattie Professionali; 2023.
21. Decree of the President of the Republic (DPR) No. 1124 of 30 June 1965 (Decreto 30 Giugno 1965 n. 1124 – Testo Unico Delle Disposizioni per l’assicurazione Obbligatoria Contro Gli Infortuni Sul Lavoro e Le Malattie Professionali).
22. Spreeuwers D, de Boer AGEM, Verbeek JHAM, van Beurden MM, van Dijk FJH. Diagnosing and Reporting of Occupational Diseases: A Quality Improvement Study. Occup Med. (Lond). 200;58:115–121. Doi: 10.1093/occmed/kqm146.
23. Violante FS. Criteria for Diagnosis and Attribution of an Occupational Musculoskeletal Disease. Med Lav. 2020;111:249–268. Doi:10.23749/mdl.v111i4.10340
24. Palmer K, Walker-Bone K, Linaker C, et al. The Southampton Examination Schedule for the Diagnosis of Musculoskeletal Disorders of the Upper Limb. Ann Rheum Dis. 2000;59:5–11. Doi: 10.1136/ard.59.1.5.
25. Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) Frameworks: A Systematic and Transparent Approach to Making Well Informed Healthcare Choices. 1: Introduction. BMJ. 2016;353:i2016. Doi:10.1136/bmj.i2016
26. Alonso-Coello P, Oxman AD, Moberg J, et al. GRADE Evidence to Decision (EtD) Frameworks: A Systematic and Transparent Approach to Making Well Informed Healthcare Choices. 2: Clinical Practice Guidelines. BMJ. 2016;353:i2089. Doi:10.1136/bmj.i2089
27. Walker HK, Hall WD, Hurst JW. Clinical Methods: The History, Physical, and Laboratory Examination; Eds.; Boston, 1990; ISBN 0-409-90077-X.
28. Sackett DL. The Rational Clinical Examination. A Primer on the Precision and Accuracy of the Clinical Examination. JAMA. 1992;267:2638–2644.
29. Kuijer PPFM, Verbeek JH, Seidler A, et al. Work-Relatedness of Lumbosacral Radiculopathy Syndrome: Review and Dose-Response Meta-Analysis. Neurology. 2018;91:558–564. Doi: 10.1212/01.wnl.0000544322.26939.09
30. van der Molen HF, Foresti C, Daams JG, Frings-Dresen MHW, Kuijer PPFM. Work-Related Risk Factors for Specific Shoulder Disorders: A Systematic Review and Meta-Analysis. Occup Environ Med. 2017; 74:745–755. Doi: 10.1136/oemed-2017-104339
31. Verbeek J, Mischke C, Robinson R, et al.. Occupational Exposure to Knee Loading and the Risk of Osteoarthritis of the Knee: A Systematic Review and a Dose-Response Meta-Analysis. Saf Health Work. 2017;8:130–142. Doi: 10.1016/j.shaw.2017.02.001
32. Pauling JD, Hughes M, Pope JE. Raynaud’s Phenomenon-an Update on Diagnosis, Classification and Management. Clin Rheumatol. 2019;38:3317–3330. Doi: 10.1007/s10067-019-04745-5
33. Hulshof CTJ, Pega F, Neupane S, et al. The Prevalence of Occupational Exposure to Ergonomic Risk Factors: A Systematic Review and Meta-Analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury. Environ Int. 2021;146:106157. Doi: 10.1016/j.envint.2020.106157
34. Siemiatycki J, Lavoué J. Availability of a New Job-Exposure Matrix (CANJEM) for Epidemiologic and Occupational Medicine Purposes. J Occup Environ Med. 2018;60:e324–e328. Doi: 10.1097/JOM.0000000000001335
35. Aekplakorn W, Suriyawongpaisal P, Methawikul, T. The Diagnosis and Reporting of Occupational Diseases: The Performance of Physicians in Thailand. Southeast Asian J Trop Med Public Health. 2002; 33:188–192.
36. Campo G, Mattioli S, Cocco P, et al. Marel: From the Network of Occupational Medicine Consultation Centres to the Analysis of Occupational Exposure Data. Med Lav. 2018;108:5–12. Doi: 10.23749/mdl.v108i1-S.6971
37. Shofer S, Haus BM, Kuschner WG. Quality of Occupational History Assessments in Working Age Adults with Newly Diagnosed Asthma. Chest. 2006;130:455–462. Doi:10.1378/chest.130.2.455.
Barra laterale dell'articolo
Dettagli dell'articolo
Come citare
Questo volume è pubblicato con la licenza Creative Commons Attribuzione - Non commerciale 4.0 Internazionale.
All Journal's articles are Open Access papers distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a CC BY-NC 4.0 Creative Commons Attribution-NonCommercial 4.0 International License.
Come citare
