Objectives The identification and recognition of occupational diseases (OD) has important and longstanding limitations in Spain. The creation of an Occupational Disease Unit (ODU) at the Parc de Salut Mar health system (PSMAR) in 2010 is among the latest innovative initiatives to address these restraints. Its aims are to identify, evaluate and report suspected cases of OD among PSMAR patients, based on the collaboration of clinical and occupational health services, and patients.
Methods Prospective clinical study of a series of suspected cases of OD identified at PSMAR between 2010 and 2014, referred to the ODU for an in-depth protocol-driven confirmatory clinical evaluation, leading to a standardised causation report. Confirmed cases were followed up to provide continued support. The official OD recognition process was tracked to determine whether it had been initiated and followed to final administrative closure.
Results A total of 115 potential cases were referred to ODU by PSMAR health system physicians, of which 46 (40%) were confirmed as cases of suspected OD. The majority of confirmed cases were men (80%), with diagnoses of hearing loss (43%), musculoskeletal disorders (24%), cancer (22%) and dermatoses (11%). The positive predictive value was 39% (95% CI = 27.39–50.99). With respect to final administrative decision, 14 of 31 patients who initiated the official recognition process were rejected, 4 remained open, and 13 had been recognised as OD. Of these, 11 were recognised by the administrative route and two through litigation. The mean time to recognition was 295 days.
Conclusions The results obtained from this experience have shown the ODU to be useful and effective. The challenge now is to expand this approach for identification and management of OD to other hospitals of the Spanish National Health Service.
Fondo de Investigaciones Sanitarias (FIS: PI12/02556), Instituto de Salud Carlos III, Subdireccion General de Evaluacion y Fomento de la Investigacion, Ministerio de Ciencia e Innovacion, Spanish Government
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