Diagnosing and Reporting of Occupational Diseases: An Assessment Study of Reports from an Italian Workplace Safety Prevention Program Service.

IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Luigi Isaia Lecca, Sergio Pili, Michele Lai, Alessandro Murru, Giuseppe Campo, Antonio Pizzuti, Stefano Mattioli, Marcello Campagna
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引用次数: 0

Abstract

Background: The criteria for diagnosing and compensating for occupational diseases vary significantly between countries. The lists of occupational diseases often include diagnostic and attribution criteria that are usually not very specific. As a result, the quality of occupational disease reports is frequently subpar. The aims of this study were to assess the quality of diagnosis and reporting, as well as to evaluate the causal link between reported occupational diseases and occupational risk factors.

Methods: Four occupational physicians assessed the quality of diagnosis by blindly applying Spreeuwers' performance indicators for diagnosis and reporting. Following Violante's criteria, the four evaluators also tested the levels of evidence to evaluate the quality (and associated likelihood) of the diagnosis and the quality of exposure to occupational risk factors in a sample of 104 occupational disease reports, grouped by diagnosis and examined by the local Workplace Safety Prevention Service. Separate scores for each performance indicator and the Total Quality Score (TQS, ranging from 0 to 10), along with the progressive levels of evidence, were then assigned for each occupational disease report.

Results: The mean TQS was below the threshold of sufficiency (<6) for 28% of the diagnoses, while an almost sufficient score (>6) emerged for 72% of the diagnoses, primarily including musculoskeletal disorders, pulmonary silicosis, and noise-induced occupational hearing loss. When applying Violante's criteria for the level of evidence of the diagnosis, it was insufficient for 13.5% of the reported cases, while the level of evidence for exposure to occupational risk factors was deemed insufficient for 19% of the cases, and no cases demonstrated a level of evidence that was highly probable or nearly certain.

Conclusions: Despite the overall quality of the reported cases of occupational diseases being reasonably good, improvements in the quality of diagnosis and reporting could be achieved through strict adherence to standardized diagnostic criteria and by training health personnel to collect data regarding occupational and non-occupational risk factors properly.

诊断和报告职业病:意大利工作场所安全预防方案服务报告的评估研究。
背景:各国诊断和补偿职业病的标准差别很大。职业病清单通常包括诊断和归因标准,这些标准通常不是很具体。因此,职业病报告的质量经常低于标准。这项研究的目的是评估诊断和报告的质量,以及评估所报告的职业病与职业风险因素之间的因果关系。方法:4名职业医师盲目应用Spreeuwers绩效指标进行诊断和报告,评价诊断质量。根据Violante的标准,四名评估人员还测试了证据水平,以评估104份职业病报告的诊断质量(以及相关的可能性)和暴露于职业风险因素的质量,这些报告按诊断分组,并由当地工作场所安全预防服务机构进行检查。每个绩效指标和总质量分数(TQS,范围从0到10)的单独得分,以及证据的渐进水平,然后分配给每个职业病报告。结果:72%的诊断中TQS低于充分性阈值(6),主要包括肌肉骨骼疾病、肺矽肺病和噪声诱发的职业性听力损失。当应用Violante的诊断证据水平标准时,13.5%的报告病例的证据水平不足,而19%的病例被认为暴露于职业风险因素的证据水平不足,没有病例显示出高度可能或几乎肯定的证据水平。结论:尽管报告的职业病病例的总体质量尚可,但通过严格遵守标准化诊断标准和培训卫生人员正确收集有关职业和非职业风险因素的数据,可以提高诊断和报告的质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medicina Del Lavoro
Medicina Del Lavoro 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.70
自引率
7.40%
发文量
42
审稿时长
>12 weeks
期刊介绍: La Medicina del Lavoro is a bimonthly magazine founded in 1901 by L. Devoto, and then directed by L. Prieti, E. Vigliani, V. Foà, P.A. Bertazzi (Milan). Now directed by A. Mutti (Parma), the magazine is the official Journal of the Italian Society of Occupational Medicine (SIML), aimed at training and updating all professionals involved in prevention and cure of occupational diseases.
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