Occupational health in the Negev: a model for regional planning

In the Negev region of Israel, I tested a model approach to occupational health planning. This model included components assessing exposures, measuring adverse health outcomes, and evaluating health services. I analyzed employment survey data, compiled an exposure data base, and carried out site visits covering 10,707 employees (over 50% of the regional industrial work force). Site visits identified exposure hazards of inorganic and organic dusts, heavy metals, chemicals, pesticides, and noise. I identified elevated relative regional injury rates by Standard Morbidity Ratios (SMRs) in a variety of industries, including sixfold increases for mining and non-metallic minerals manufacture (SMR 6.8, 99% CI 6.1-7.7). Review of biological monitoring data suggested deficiencies in pesticide and heavy metals surveillance. A survey of primary care clinics estimated 13,707 cases of occupational injury and illness untreated by existing occupational medical services. Based on these findings, I formulated regional occupational health planning goals, including targeting high-risk industries for increased preventive activities. This regional approach, combining multiple measures of occupational health status, can serve as a model for assessing local public health planning needs.