Sentinel surveillance of occupational diseases: a quality improvement project

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.