Objectives Underreporting of occupational diseases (OD) is an important issue worldwide. To address this problem, we projected a Cochrane review to evaluate the effect of interventions aimed at reducing the underreporting of OD by physicians.
Methods We will include randomised controlled trials (RCT), cluster-RCT, controlled before-and-after (CBA) and interrupted time-series (ITS) studies. We will include any type of intervention acting directly or indirectly to influence the behaviour of physicians. As primary outcome, we will define the reporting of OD either measured as the number of physicians reporting or as the number of OD reported per physician. Pairs of authors will independently screen the titles and abstracts of the search strategy results. Potentially relevant articles will be obtained in full text and independently assessed for inclusion.
Results A preliminary search to locate RCT was conducted in Medline (through Pubmed) up to November 2012. The search strategy identified 137 potentially pertinent articles. Of these, three articles met the inclusion criteria. Two RCT were conducted in high income countries (the Netherlands and United States), while the other one was conducted in Nigeria. Two studies evaluated the effect of informative interventions, the third one evaluated the effect of a training programme. Results indicate insufficient evidence for the effect of informative interventions for reducing the underreporting of OD (1 RCT on occupational physicians, not effective - 1 RCT on physicians, effective). On the other hand, training had a positive effect on health personnel knowledge, reporting requirement and the timeliness and completeness of the disease surveillance and notification system.
Conclusions These preliminary results, not including data from future searches regarding CBA and ITS, highlight the widespread problem of underreporting of OD. More high quality RCT are needed to evaluate the effect of interventions which could be applied to increase the reporting of OD in different contexts and countries.
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