Development and validation of an occupational health triage tool

BACKGROUND

As work and health are closely interlinked, it is important to carefully monitor employees. However, limited resources restrict in-depth follow-up.

AIMS

This study was aimed to develop a low-cost screening instrument for employees' overall health status, that can be used across industries and that allows triaging workers to in-depth health surveillance in case of indications of health or functioning problems.

METHODS

We developed a new questionnaire-based algorithm built on multiple predictors to assess the need for further follow-up. We used a systematic review, Delphi panel (n = 9) and focus group (n = 5) to determine the predictors, tested for language pitfalls in a pilot study and evaluated the questionnaire's validity in two separate studies. Study 1 (n = 60) analysed the discriminatory power of the instrument by comparing it to the assessment of an occupational physician in a sample of employees from diverse occupational settings. Study 2 (n = 869) appraised the factor structure and internal consistency of the screening tool in a sample of employees from the hospital sector.

RESULTS

Risk factors, current physical and mental health, functioning, absenteeism, job satisfaction and lifestyle were identified as the most relevant predictors. Study 1 showed the survey had good criterion validity (area under the curve = 0.72). Study 2 (N = 869, 28% response) demonstrated the internal consistency (Cronbach's α = 0.94), and a factor analysis confirmed a second-order factor structure with adequate model fit (comparative fit index = 0.96, root mean square error of approximation = 0.04 and standardized root mean square residual = 0.07).

CONCLUSIONS

This questionnaire can be used to triage workers for occupational health follow-up and can, additionally, be useful to describe the epidemiology of work-related illness.

A scoping review to identify strategies that work to prevent four important occupational diseases

BACKGROUND

Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts.

METHODS

To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants.

RESULTS

We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity.

CONCLUSIONS

This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.

Trends in work-related mental disorders by sector in France

Background

Notifications of work-related mental disorders (WRMDs) are increasing while little data are available on trends by industrial sector.

Aims

To assess WRMD notifications and trends from 2001 to 2011 by industrial sector using data collected by the French National Network for Occupational Disease Vigilance and Prevention (RNV3P) network.

Methods

We calculated standardized notification ratios (SNRs) per sector. To analyse trends over time, we used odds ratios, analysed by logistic regression, including time as a discrete variable or as a continuous variable.

Results

We found higher than expected WRMD notifications in manufacturing; paper and book (SNR = 2.16; 95% CI [1.88-2.48]), chemical and pharmaceutical (SNR = 1.79; 95% CI [1.58-2.03]), textile and clothing (SNR = 1.27; 95% CI [1.04-1.54]). In the trade sectors, retail (SNR = 1.60; 95% CI [1.52-1.68]), motor vehicle and cycle trade and repair (SNR = 1.19; 95% CI [1.05-1.34]). In the services sector personal (SNR = 2.09; 95% CI [1.83-2.38]), information technology (SNR = 1.54; 95% CI [1.36-1.74]), financial and insurance (SNR = 1.42; 95% CI [1.31-1.53]), post and telecommunication (SNR = 1.44; 95% CI [1.30-1.60]), human health and social work (SNR = 1.29; 95% CI [1.24-1.34]). We found an increase in notifications in agriculture, post-telecommunication services and the human health/social work sectors and a decrease in chemical/pharmaceutical, metal, and paper and book manufacturing sectors (P < 0.05).

Conclusions

These results reveal trends in notifications for WRMDs by industrial sector. This highlights the importance of monitoring trends in WRMDs in specific worker subsets, using specialized networks such as the RNV3P.

Worldwide trends in incidence in occupational allergy and asthma

PURPOSE OF REVIEW

Recent improvements in the methods for analyzing trends in occupational health surveillance and the prospect of future improvements in the collecting and sharing of electronic data alongside increasing availability of linked datasets make this a good time to review the existing literature on trends in occupational allergy and asthma (OAA).

RECENT FINDINGS

There is a notable lack of reports of recent trends in OAA in the academic literature and much of the published work comes from European countries. The incidence of OAA appears to be declining based on physician-reporting or recognized compensation claims for the countries with published data. However, we need to be cautious in interpreting this as a decline in the 'true' incidence of OAA. Few of the studies adjusted appropriately for changes in the population at risk and one of the most robust study designs showed no change in the incidence of allergic contact dermatitis in contrast to the other studies.

SUMMARY

Many existing datasets have the potential to be used to examine trends, and studies from Canada show the potential of using linked databases for surveillance. We hope that this review will encourage improvements in the analysis, and more dissemination, of trends.

Geographic dimensions of a health network dedicated to occupational and work related diseases

Background

Although introduced nearly 40 years ago, Geographic Information Systems (GISs) have never been used to study Occupational Health information regarding the different types, scale or sources of data. The geographic distribution of occupational diseases and underlying work activities were always analyzed independently. Our aim was to consider the French Network of Occupational Disease (OD) clinics, namely the “French National OD Surveillance and Prevention Network” (rnv3p) as a spatial object in order to describe its catchment.

Methods

We mapped rnv3p observations at the workplace level. We initially analyzed rnv3p capture with reference to its own data, then to the underlying workforce (INSEE “Employment Areas”), and finally compared its capture of one emblematic occupational disease (mesothelioma) to an external dataset provided by a surveillance system thought to be exhaustive (PNSM).

Results

While the whole country is covered by the network, the density of observations decreases with increase in the distance from the 31 OD clinics (located within the main French cities). Taking into account the underlying workforce, we show that the probability to capture and investigation of OD (assessed by rates of OD per 10,000 workers) also presents large discrepancies between OD clinics. This capture rate might also show differences according to the disease, as exemplified by mesothelioma.

Conclusion

The geographic approach to this network, enhanced by the possibilities provided by the GIS tool, allow a better understanding of the coverage of this network at a national level, as well as the visualization of capture rates for all OD clinics. Highlighting geographic and thematic shading zones bring new perspectives to the analysis of occupational health data, and should improve occupational health vigilance and surveillance.

Electronic supplementary material

The online version of this article (doi:10.1186/s12942-016-0063-7) contains supplementary material, which is available to authorized users.