THE NETHERLANDS: Experimentation to improve the detection and prevention of occupational diseases

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In 2014, the NCvB started a project to improve the screening, diagnosis, reporting and prevention of occupational diseases during case management of patients by the industrial doctor. This project, in which the NVAB (Dutch association for industrial and corporate medicine) actively took part, resulted in the establishment of an experiment with 230 doctors, in which a control group of 120 doctors applied the old procedure and an experimental group applied the new one.

Until 2014, the industrial doctors followed a 5-stage plan:

  • Determining health complaints;
  • Determining possible links between the disease and the occupational activity;
  • Determining the nature and level of occupational exposure (physical, chemical, psychosocial, etc.);
  • Determining other possible explanations for the occurrence of the disease, and the role of individual susceptibility;
  • Conclusion and report.

As part of the project, a sixth stage, focused on prevention, was added and the 5-stage plan was revised to facilitate its use. The actions carried out and the decisions taken by 100 industrial doctors (50 in each group) regarding screening, diagnosis, reporting and prevention of occupational diseases were then assessed according to several performance indicators, including a comparison with the exposure criteria adopted in the NCvB’s recommendations for the registration of occupational diseases, and substantiation of the link between disease and occupational activity. On average, for these indicators the industrial doctors of the experimental group obtained a far higher total score than the control group.

The industrial doctors who took part in this experimental project were generally satisfied. However, they expressed concern regarding the time that had to be invested to follow the 6-stage plan and to report an occupational disease.

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