Occupational Disease Surveillance Research Articles

Occupational Skin Diseases in Korea

Skin disease is the most common occupational disease, but the reported number is small in Korea due to a difficulty of detection and diagnosis in time. We described various official statistics and data from occupational skin disease surveillance system, epidemiological surveys and cases published in scientific journals. Until 1981, 2,222 cases of occupational skin disease were reported by Korean employee's regular medical check-up, accounting for 4.9% of the total occupational diseases. There was no subsequent official statistics to figure out occupational skin diseases till 1998. From 1999, the Korea Occupational Safety and Health Agency (KOSHA) published the number of occupational skin diseases through the statistics of Cause Investigation for Industrial Accidents. A total of 301 cases were reported from 1999 to 2007. Recent one study showed the figures of compensated occupational skin diseases. Many of them belonged to daily-paid workers in the public service, especially forestry workers. Also, it described the interesting cases such as vitiligo and trichloroethylene-induced Stevens-Johnson Syndrome. Skin diseases are still important though the number of cases has decreased, and therefore it is recommended to grasp the status of occupational skin diseases through continuous surveillance system and to make policy protecting high-risk group.

Area-Based Occupational Disease Surveillance in Incheon, Korea: Results of an 11-year Data Survey

Area-Based Occupational Disease Surveillance in Incheon, Korea: Results of an 11-year Data Survey

Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P)

ObjectiveThe French national occupational disease surveillance and prevention network (RNV3P) includes the 30 occupational disease consultation centres in university hospitals to which patients are referred for potentially work-related diseases, and...

Population-based asbestosis surveillance in British Columbia

Objectives:To investigate the use of multiple health data sources for population-based asbestosis surveillance in British Columbia, Canada.Methods:Provincial health insurance registration records, workers’ compensation records, hospitalisation records, and outpatient medical service...

Filing for Workers’ Compensation among Ontario Cases of Mesothelioma

For many types of cancer, disease attribution to occupational exposures is difficult. Mesothelioma, however, is a 'sentinel' occupational cancer associated with asbestos exposure. The present study linked workers' compensation claims data with cancer registry data to explore the completeness of reporting of mesothelioma to the Ontario Workplace Safety and Insurance Board (WSIB) according to characteristics of cases diagnosed among Ontario residents. Two data sources were linked at the person level: the WSIB Occupational Disease Information and Surveillance System and the Ontario Cancer Registry. Filing rates were calculated as the proportion of Ontario Cancer Registry mesothelioma cases (International Classification of Diseases - Oncology code 905) that linked to a WSIB-filed cancer claim. Filing rates were calculated for the period 1980 to 2002, and trends were calculated by year, age and county of residence at diagnosis. The filing rate for compensation has increased little over the past 20 years, reaching a high of 43% in 2000. Overall, filing rates were highest among pleural mesothelioma cases among men (range 27% to 57%). Filing rates were highest among individuals 50 to 59 years of age and declined substantially throughout the retirement years. There was substantial variation in filing rates by area of residence, with the highest rate being in Lambton County, Ontario. The filing rate for compensation in Ontario was much lower than the estimated proportion of cases eligible for compensation. The increased filing rate in Lambton County was likely related to this community's awareness of the association between asbestos and mesothelioma. Physicians can play an important role in educating patients of their potential entitlement to compensation benefits.

Occupational Disease Among Non-Governmental Employees in Malaysia: 2002-2006

In the absence of systematic occupational disease surveillance, other data collected by governmental agencies or industry is useful in the identification of occupational diseases and their control. We examined data on occupational diseases reported by non-governmental employees to the national workers' social security organization in Malaysia, 2002-2006. The overall incidence rate of occupational disease was 2.8 per 100,000 workers. There was an increase in the annual number and rates of occupational disease over time. The most frequently reported conditions were hearing impairment (32%) and musculoskeletal disorders (28%). Workers in the non-metallic manufacturing industry had the highest average incidence rate of hearing impairment (12.7 per 100,000 workers) and musculoskeletal disorders (3.5 per 100,000 workers), compared to all other industries. Preventive measures should focus on safety education, engineering control and workplace ergonomics. Enforcing workplace standards and incorporating an ongoing surveillance system will facilitate the control and reduction of occupational disease.

Sentinel surveillance of occupational diseases: A quality improvement project

Occupational diseases are generally underreported. The aim of this study was to evaluate whether a sentinel surveillance project comprising motivated and guided occupational physicians would provide higher quality information than a national registry for a policy to prevent occupational diseases. A group of 45 occupational physicians participated in a sentinel surveillance project for two years. All other occupational physicians (N = 1,729) in the national registry were the reference group. We compared the number of notifications per occupational physician, the proportion of incorrect notifications, and the overall reported incidence of occupational diseases. The median number of notifications per occupational physician during the project was 13.0 (IQR, 4.5-31.5) in the sentinel group versus 1.0 (IQR, 0.0-5.0) in the reference group (P < 0.001). The proportion of incorrect notifications was 3.3% in the sentinel group and 8.9% in the reference group (P < 0.001). The overall reported occupational disease incidence was 7 times higher (RR = 6.9, 95% CI: 6.5-7.4) in the sentinel group (466 notifications per 100,000 employee years) than in the reference group (67 notifications per 100,000 employee years). A sentinel surveillance group comprising motivated and guided occupational physicians reported a substantially higher occupational disease incidence and a lower proportion of incorrect notifications than a national registry.

Work‐related asthma in the Educational Services industry: California, Massachusetts, Michigan, and New Jersey, 1993–2000

To characterize work-related asthma (WRA) cases working in the educational services industry identified by state-based occupational disease surveillance systems. We examined 2,995 WRA cases reported from 1993 to 2000 to four states: California, Massachusetts, Michigan, and New Jersey. A total of 265 (9%) WRA cases were employed in the educational services industry; 69% of cases were classified as new-onset asthma and 31% as work-aggravated asthma. New-onset asthma cases were further classified as occupational asthma (61%) or as reactive airways dysfunction syndrome (8%). The most frequently reported occupation was teachers and teachers' aides (54%). The most frequently reported agents were indoor air pollutants (28%), unspecified mold (16%), dusts (14%), and cleaning products (7%). Asthma within the educational services industry is an occupational health problem. The health of school employees should also be considered when initiatives addressing asthma among schoolchildren are instituted. The identification, elimination, and/or control of respiratory hazards are important factors for the protection of staff and students alike.

Surveillance of occupational disease

Surveillance of occupational disease

Detection of emerging diseases in occupational health: usefulness and limitations of the application of pharmacosurveillance methods to the database of the French national occupational disease surveillance and prevention network (RNV3P)

Objective:To test data mining methods used in pharmacosurveillance in order to identify potential emerging disease–nuisance associations in the national occupational disease surveillance and prevention network (RNV3P) database.Methods:Proportional reporting ratios (PRR)...

Automatic Detection of New Occupational Health Problems (OHP) From Data of the National Occupational Disease Surveillance Network

P-565 Background: The National Occupational Disease Surveillance Network (RNVPP, Réseau National de Vigilance des Pathologies Professionnelles) was set up in 2001 as a network of experts which registers all occupational health problems (OHPs) based on occupational health consultations at university hospitals in mainland France, corresponding to 5,000 OHPs per annum. Each OHP is attributed a disease code (CIM10), 1–5 nuisances codes (INRS), an occupation code (ILO) and a type of activity code (NAF). Aims: To test statistical methods for signal detection in order to identify as yet unrecognized links between disease and nuisance, which warrant evaluation by the experts. Methods: A literature search addressing signal detection methods used in different surveillance systems was carried out. The methods used for pharmacovigilance (based on “event*drug” matrices) correspond most closely to our needs (i.e. a “disease* nuisance” matrix): seven of these were applied to the RNVPP. Results: Six of the seven methods investigated gave 75±5% positive signals (using the same thresholds as in pharmacovigilance). This high rate of positive signals is consistent with the high proportion of tight links already recognized in the network and identified automatically. Links that gave a positive signal were broken down according to their degree of recognition on first principles. Several unrecognized (and possibly suspected) links were detected (including trichloroethylene and cancer of the kidney, and pesticides and prostate cancer or sarcoma). Finally, the sensitivity of the various methods was compared in terms of the number of times the pair was identified. A number of filters are currently available to facilitate the detection of emerging links. These allow detection of recognized, compensated links (the MPI filter) and recognized but uncompensated links (the expert filter), and make it possible to use correlations between the various diseases and degrees of impact (the modelling filter). Conclusion: Future research will address the temporal and spatial profiles of detected links with the ultimate goal of being able to apply the methods on a routine basis to identify emerging links at an early stage, and sound an alarm.

Hypersensitivity pneumonitis due to metal working fluids: Sporadic or under reported?

Occupational exposure to metal working fluids (MWF) is common with over 1.2 million workers in the United States involved in machine finishing, machine tooling, and other metalworking operations. MWF is a known cause of hypersensitivity pneumonitis (HP). Recent reports of outbreaks of hypersensitivity HP secondary to exposure to MWF are reported. Cases were identified through the Occupational Disease surveillance system in the State of Michigan and from referrals for evaluation to the Division of Occupational and Environmental Medicine at Michigan State University (MSU). Each patient underwent a clinical examination including an occupational history, lung function studies, radiographic imaging, and in some cases lung biopsies. Following the diagnosis of definite HP, an industrial hygiene investigation was carried out, which included a plant walk-through, and review of the "Injury and Illness" log. Air monitoring and microbial sampling results were reviewed. As part of Michigan's mandatory surveillance system for occupational illnesses, seven cases of suspected HP were identified in 2003-2004 from three facilities manufacturing automobile parts in Michigan. Each plant used semi-synthetic MWFs, and conducted a MWF management program including biocide additions. Two facilities had recently changed the MWF before the cases arose. Growth of mycobacteria was found in these two MWFs. Breathing zone samples for particulates of two employees in plant A (two cases) ranged from 0.48 to 0.56 mg/m3. In plant B (four cases), two employees' sampling results ranged from 0.10 to 0.14 mg/m3. No air sampling data were available from plant C. Hypersensitivity pneumonitis due to exposure to MWFs is under-recognized by health care providers, and current surveillance systems are inadequate to provide a true estimate of its occurrence. HP arose from environments with exposures well below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for MWF, and in one case from exposures well below the National Institute of Occupational Safety and Health (NIOSH) recommended exposure limit (REL). The sporadic nature of reports of HP in relationship to MWF probably represents a combination of workplace changes that cause the disease and inadequate recognition and reporting of the disease when it does occur. Physician awareness of HP secondary to MWF and an effective medical surveillance program are necessary to better understanding the epidemiology and prevention of this disease.

Occupational hand–arm vibration syndrome in Korea

It is suspected that there is a large number of patients suffering from hand-arm vibration syndrome (HAVS) in Korea. However, no cases have been reported since 1992. This study was conducted to identify HAVS cases and determine the characteristics of the syndrome. In April 2001, the Busan, Ulsan, and Gyeong-Nam Province Occupational Disease Surveillance System (BUGODSS) was established to identify work-related HAVS and other occupational diseases. In the 2 years of this project, occupational physicians from five hospitals in these provinces collected information by way of interviews and questionnaires during mandatory occupational medical examinations. Among the initial 189 suspected HAVS cases, 58 volunteers were given cold-water provocation tests in order to diagnose the vascular component of the disorder. One hundred fifty-four approximately occupational HAVS cases were identified from ca. 21,000 workers. One hundred fifty about of these cases were male. The cases were most often found in workers from the shipbuilding industry, and the grinder was the most common source of vibration exposure. Cases of sensorineural disorder (SD) were more common than cases of vascular disorder (VD). The mean values of the finger skin temperature and its recovery rate at 5 min and 10 min after cold-water provocation were significantly lower in the group with the VD than in the group with the SD. We identified 154 occupational HAVS cases, although no cases have been reported during the occupational medical examinations mandated by the state. The majority of the cases were in workers that used grinders in the shipbuilding industry. We determined that peripheral VD and peripheral SD can progress independently of each other. We conclude that exposure to hand-transmitted vibration (HTV) and HAVS cases are common in shipbuilding industry in Korea. The recovery rate of finger skin temperature after cold-water provocation is one of the useful methods for diagnosing the vascular component of HAVS.

Occupational allergy as a challenge to developing countries.

A steady increase in the incidence of allergic diseases can be observed since 1950s. For such atopic diseases as bronchial asthma, pollinosis or atopic dermatitis, a significantly increased morbidity rate in the general population has been found. Strikingly enough, the highest prevalence of asthma and allergy was recorded in highly developed countries. It can thus be assumed that the high rate of asthma may be an attribute of the post-industrial societies. The prevalence of occupational allergies is thought to be in direct proportion to the rate with which allergies occur in the general population. In view of the changing environment and lifestyles in the developing countries, their communities are expected to be faced with similar negative epidemiological effects concerning allergies. To counteract the spreading of negative health effects, the following measures need to be undertaken: 1. Limitation of exposure to strong allergens. 2. Modification of the training curriculum for medical personnel and of health service infrastructure, according to new tasks and challenges. 3. Considering a possibility of introducing a system of surveillance over occupational allergies and asthma, like the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) system implemented in UK. This system ensures effective cooperation between specialists in preventive medicine, occupational hygiene services and research workers dealing with occupational health that enables prompt response to emerging hazards.

Occupational disease surveillance system in Busan, Ulsan, Kyung-Nam area

Occupational disease surveillance system in Busan, Ulsan, Kyung-Nam area

Occupational contact dermatitis to nickel: experience of the British dermatologists (EPIDERM) and occupational physicians (OPRA) surveillance schemes

Aims: To examine, from occupational surveillance reporting data, whether scheme reporters considered nickel exposure to play a role in occupational contact dermatitis (OCD) in the UK. Methods: Data on occupational...

Epidemiologic Characteristics of Hand-Arm Vibration Syndrome through Occupational Disease Surveillance System in Busan, Ulsan, Kyungnam Province

OBJECTIVES: The objectives of this study were to estimate the epidemiologic characteristics of hand-arm vibration syndrome (HAVS) due to occupational exposure of hand transmitted vibration and to identify the occupations and industries where such exposures arises, and the main sources of exposure.METHODS: In April 2001 the Busan, Ulsan, and Kyung-Nam Province occupational disease surveillance system was established to measure the incidence and prevalence of work-related HAVS and other occupational diseases in these Korean provinces. Occupational physicians of nine hospitals in Busan, Ulsan, and Kyung-nam Province were involved in this project between April 2001 and November 2002. Physicians collected information through questionnaires and interviews. Information gathered included age, occupation, types of vibration tools used and presence of subjective symptoms such as vibration-induced white finger (VWF), numbness and tingling.RESULTS: A total 192 cases were reported with 188 males and 4 females. The shipbuilding industry was the most common type of industry and grinders were the most common source of exposure. Symptoms of neurological disorder were more common than those of vascular disorder.CONCLUSIONS: The authors concluded that exposure to hand transmitted vibration is common and that HAVS is one of the most common occupational diseases in Korea. However, the range and extent of hand transmitted vibration and the overall prevalence of HAVS in Korea is still unknown. More extensive research on this syndrome in order to priorite necessary preventive measures is required.

Recent developments in airway and nose occupational sensitizers.

To describe the latest developments in the field of occupational asthma and occupational rhinitis in 2001 and 2002. Several surveillance programs of occupational diseases, such as Observatoire National des Asthmes Professionnels in France, Surveillance of work-related and Occupational Respiratory Diseases in South Africa (SORDSA), Surveillance of Work-related and Occupational Respiratory Diseases (SWORD) in UK, have reported on the frequency of occupational asthma. The causative agents were mainly flour, isocyanates and latex. The common methods of diagnosis - questionnaires, cutaneous tests, Peak Expiratory Flow Rate (PEFR), bronchial hyperresponsiveness - still create controversy. In addition, the specific bronchial challenge, the classical gold standard of diagnosis, has its limitations since it cannot be performed in every case. Other methods have been assessed as inflammatory markers in induced sputum. Occupational rhinitis appears to be a poorly diagnosed condition. Further studies are expected to explore the effect of environmental control and medical surveillance. The key to successful management of occupational asthma and occupational rhinitis may be prospective surveillance of the occurrence of specific IgE antibodies before the onset of allergic symptoms.

The estimated workforce served by occupational physicians in the UK.

During the past decade, an occupational disease surveillance scheme has been created in the UK, based on systematic reporting of newly diagnosed cases by six groups of clinical consultants and by specialist occupational physicians. Labour Force Survey statistics have proved a reasonably satisfactory denominator for the former, but not for the occupational physicians, who provide services for only a selected subsection of the employed population. To remedy this deficiency, approximately 700 occupational physicians who were recorded as having been a reporter at some time were invited to provide their best estimate of the number of employees for whom they were responsible. After various exclusions--mainly physicians who were not, or were no longer, responsible for any defined workforce, and others who had not reported for at least 3 years--the number of active participants for whom data, by industry, occupation and sex, were obtained or estimated was 503. The resulting total number of employees served was estimated at 3.2 million, comprising 12% of the general working population. The proportion with access to an occupational physician varied enormously, from 43% in the health and social services to 1% in agriculture, forestry and fishing, and 6% in the rest of industry. Numbers estimated for each industrial sector were fairly reliable, but by occupation less so, especially in the health and social services.

Case-Referent Survey of Young Adults with Mesothelioma: II. Occupational Analyses

Our study aimed to identify occupations at increased risk of developing mesothelioma in persons aged 50 yr or less, and to relate these occupations to lung tissue concentration of asbestos fibres by type. In this age group it was thought that most, but not all, work-related exposures would have been since 1970, when the importation of crocidolite, but not amosite, was virtually eliminated. Eligible cases were sought from recent reports by chest physicians to the SWORD occupational disease surveillance scheme. Work histories were obtained for 115 men and 13 women, usually with the help of the chest physicians or coroners. Jobs were coded by the Office of National Statistics, so that the observed years spent in each occupation could be compared with expected values from census data, 1960-90. Lung tissue samples were obtained at autopsy from 69 male and four female cases, and mineral fibres identified, sized and counted by electron microscopy. Of 37 industrial occupations analysed, odds ratios were significantly raised in eight: five in the construction industry and the others in shipbuilding, the manufacture of cement products and the manufacture of non-metallic mineral products (including asbestos). The concentrations in lung of crocidolite and amosite fibres, which together could account for 80-90% of cases, did not differ between occupational categories; those for amosite were appreciably higher than for crocidolite. Tremolite fibres were rarely found. Mesothelioma in this young age group is dominated by carpenters, plumbers, electricians and insulators in the construction industry, and is mainly attributable to amphibole exposure. Work in shipbuilding and manufacture of mineral products was less important than in earlier studies. Contrary to expectation, however, some 90% of cases were in men who had started work before 1970.