[Identification of occupational diseases in a tertiary care hospital]

Official recognition of occupational diseases (OD) in Spain is very poor. In 2010, the Occupational Disease Unit (ODU) of Parc de Salut Mar (PSMAR) was created to identify and report the suspect of OD among hospital patients. The aim of the study is to analyze the activity of the Occupational Disease Unit between 2010 and 2012.

Patients evaluated by the Occupational Disease Unit were identified through referrals from clinical services and retrospective reviews of selected pathologies from the hospital discharge register in the period 2010-2012. Cases are evaluated systematically, using an evidence-based approach to assess the relationship between occupational exposures and disease. We analyze the frequency of cases together with the positive predictive value (PPV) and corresponding 95% confidence intervals (95%CI) for the confirmation procedure as suspected cases of OD according to the case origin, diagnostic group, age and sex.

From a total of 140 patients with suspected OD identified by the Occupational Disease Unit, 47% were located through retrospective reviews of the hospital discharge registries (n=66) and the remainder from clinical services referrals (n=74). Among these cases 54% were cancers, 21% hearing losses, 16% musculoskeletal disorders, 6% dermatological diseases, 2% respiratory tract diseases and 1% neurological diseases. The Occupational Disease Unit confirmed suspected OD in 34 cases. The PPV for cases referred from clinical services was 39% (95% CI = 27.39-50.99) and 7.6% (95% CI = 0.43-14.72) for the discharge register retrospective review.

Hospitals can contribute to the identification of OD, and referral of suspected OD by clinical services to a specialized occupational medicine unit is recommended as the most appropriate strategy.