Evaluation of occupational disease surveillance in six EU countries.

BACKGROUND Registries of occupational diseases in various European countries differ considerably in criteria for notification and recognition, statistical data provided and the legal and social security context. Therefore, figures on occupational diseases are not comparable between countries and are often regarded as not reliable even within a country. Still, registries of occupational diseases are an important source for policy on occupational safety and health. AIMS To evaluate registries of occupational diseases in European (EU) countries for their ability to provide appropriate information for preventive policy. METHODS Contact persons of national registries for occupational diseases in six countries were sent a questionnaire on the objectives of their registry and on the quality of monitoring time trends and alerting to new risks. An auditor then visited each contact person, discussed the completed questionnaire and sent a draft audit report to the contact person for verification. Two reviewers then established a quality score based on the verified audit report. The results of the audit were sent to each contact person, who was asked to evaluate the usefulness of the audit instrument for future quality improvement of the registry. RESULTS The objectives of the registries assessed in the six countries were compensation, provision of statistics, prevention and research. The average quality was rated 3.2 (SD 2.2) out of 10 for monitoring occupational diseases and 5.3 (SD 1.4) out of 10 for alerting to new risks. The main reasons for the low scores were inadequate education and training of physicians and poor participation of notifying physicians. Three of the six contact persons (50%) agreed that the audit could actually contribute to future quality improvement of the registry in relation to prevention. CONCLUSIONS Registries in EU countries do not adequately monitor existing occupational diseases or adequately alert to newly occurring occupational diseases. There is an urgent need to improve the education and participation of notifying physicians.