Physician-based surveillance of occupational disease: developing a methodology

Area of Science:

• Occupational Medicine
• Public Health Surveillance
• Health Informatics

Background:

• Current occupational disease surveillance in the U.S. relies on inadequate data.
• Physician and hospital records offer a potential alternative data source.
• Rutstein's sentinel health event (occupational) classification provides a framework for identifying relevant cases.

Purpose of the Study:

• To assess the feasibility of using physician and hospital records for occupational disease surveillance.
• To compare the effectiveness of prospective versus retrospective data collection methods.

Main Methods:

• Utilized Rutstein's sentinel health event (occupational) classification.
• Employed sentinel physicians to identify cases.
• Collected data on nonmalignant dermatologic and respiratory diagnoses prospectively and retrospectively at multiple sites.

Main Results:

• Identified 49 patients with probable work-related illnesses.
• The prospective approach required less than 10% of the time compared to the retrospective approach for case identification.
• Prospective data were found to be more timely and accessible.

Conclusions:

• The prospective use of physician and hospital records, guided by sentinel physicians, is a feasible method for occupational disease surveillance.
• Prospective surveillance is a more efficient and effective approach than retrospective methods for identifying work-related illnesses.