OCCUPATİONAL DİSEASES İN THE NETHERLANDS: İNCİDENCE, TYPE, CONSEQUENCES AND RİSK FACTORS Romy Steenbeek 1, Liza van Dam 1, Ernest de Vroome 1, Henk van der Molen 2, Petra Eysink 3, Anita Venema 1 1 The Netherlands Organisation for Applied Scientific Research 2 Netherlands Center for occupational Diseases 3 National Institute for Public Health and the Environment
WHY DO WE NEED DATA ON OCCUPATİONAL DİSEASES? 1 Diagnosis 7 Prevention 2 Notification 6 Rehabilitation 3 Registration 5 Treatment 4 Compensation
NATİONAL DATA ON OCCUPATİONAL DİSEASES Three main national sources: 1. National Working Conditions Survey: TNO and National Bureau of Statistics 2. Surveillance project for Intensive Notification: National Center for Occupational Diseases 3. Morbidity and mortality data: National Institute for Public Health and the Environment
ESTİMATES OF MORTALİTY DUE TO OD S Based on death certificates registration and Population Attributive Fractions All ODs Cancer related ODs Total number of deaths due to ODs 4,100 2,700 Number of workers deaths due to ODs Number of retired workers deaths due to ODs 900 3,200
ESTİMATES OF MORBİDİTY DUE TO OD S (INCİDENCE/YEAR) Source Self report by employees Reporting by occupational physicians Reporting by family physicians Number of employees with new ODs Percentage of employees with new ODs Number of new ODs in working population 212,000 13,000 3.2% 0,19% 430,000
ANALYSİS AND COMPARİSON OF SOURCES 1. National Working Conditions Survey: TNO and National Bureau of Statistics Pro s: Structural and representative survey of employees and self-employed Additional data on employee and work characteristics Con s: No data on informal workers, pensioners and those unable to work Self-reported, no medical data and no official medical diagnoses No data on deaths
ANALYSES AND COMPARİSON OF SOURCES 2. Surveillance project for Intensive Notification: National Center for Occupational Diseases Pro s: Medical data Official medical diagnoses based on national list of occupational diseases Con s: Limited additional data on employee and work characteristics No data on self-employed, informal workers, pensioners and those unable to work No representative sample of occupational physicians
ANALYSİS AND COMPARİSON OF SOURCES 3. Morbidity and mortality data: National Institute for Public Health and the Environment Pro s: Administrative data Data from the total working and non working population Con s: No additional data on employee and work characteristics Not all diseases included Work-relatedness estimated
INCİDENCE NWCS SURVEY Sector Distribution (%) Frequency (%) Agriculture 1 1.3 Industry 14 3.7 Building industry 5 3.6 Wholesale and retail business 16 3.0 Transport and storage 5 2.9 Food service industry 4 2.9 Information and communication 3 2.8 Financial institutions 3 2.2 Corporate service / real estate 13 3.1 Public administration 6 2.5 Education 6 2.7 Healthcare and welfare services 22 4.0 Culture, sports and recreation / remaining services 3 2.9 Total 100 3.2
INCİDENCE NWCS SURVEY Occupational disease Frequency (%) Musculoskeletal occupational disease 1.7 Psychosocial occupational disease 1.4 Other occupational disease 0.7 Total occupational disease 3.2
ADDİTİONAL CONCLUSİONS FROM THE NWCS ON ODS Risk groups 1. Incidence is higher for women 2. Incidence is higher for employees with lower education Costs 1. Presence of OD results in 25 extra days of absence from work per employee 2. Costs of occupational accidents and diseases add up to 8 billion euros
MOST PROMİNENT WORKİNG CONDİTİONS ASSOCİATED WİTH ODS MSDs 1st 2nd 3d Repetitive movements Awkward postures High job demands Psychosocial ODs Low level of engagement Conflicts with managers Heavy emotional burden of work
CONCLUSİONS 1. Data are estimates and must be interpreted with care 2. Definitions and population under consideration differ 3. There is no golden standard 4. Multi-source approach gives better picture 5. Data are needed to work on prevention
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THANK YOU! Please contact me for more information. anita.venema@tno.nl
DİSTRİBUTİON OF TYPE OF OD S MOST PROMİNENT TYPE OF OD Source Survey employe es Surveillan ce occupatio nal physician s Registrati on family physician s Musculosketal diseases x x Psychosocial diseases x
INCİDENCE NWCS SURVEY Occupational disease Frequency (%) Burn-out 1.2 Depression 0.4 Posttraumatic Stress Disorder 0.1 Remaining psychosocial occupational disease 0 Repetitive Strain Injury 0.8 Lower back problems 0.6 Arthrosis of the hip 0.1 Arthrosis of the knee 0.2 Remaining musculoskeletal occupational disease 0.2 Contact Eczema 0.1 Infectious disease (work-related) 0 Asthma 0 Chronic Obstructive Pulmonary Disease 0 Hearing problems 0.1 Remaining other occupational disease 0.1 Cancer 0