Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P).
- Caroline De Clavière (caroline.de-claviere{at}afsset.fr)
- Michel Aptel (michel.aptel{at}afsset.fr)
- Gérard Lasfargues (gerard.lasfargues{at}afsset.fr)
- Regis de Gaudemaris, for RNV3P (rdegaudemaris{at}chu-grenoble.fr)
- Published Online First 22 September 2009
Abstract
Objective: The French national occupational disease surveillance and prevention network (RNV3P) includes the 30 occupational disease consultation centres in university hospitals, where patients are referred for a potentially work-related disease, and an occupational health service (OHS). The aim of this work is to demonstrate the contribution of this network to national health surveillance.
Methods: Data from consultations are recorded in standardised occupational health reports and coded using international or national classifications. Programmed health surveillance is carried out through annual follow-up of annual referrals to experts for pre-selected disease-exposure associations, as well as incidence estimations for the well characterized working population followed by the OHS. Hypotheses on new emerging diseases are generated using statistical methods employed in pharmacosurveillance and by modelisation as an exposome to analyse multiple exposures.
Results: 58 777 occupational health reports were collected and analysed from 2001 to 2007. Referrals to the 30 university hospital centres increased significantly for asbestos-related diseases, mood disorders and adjustment disorders related to psychological and organisational demands, and for elbow and shoulder disorders related to manual handling. Referrals significantly decreased for asthma, rhinitis related to exposure to organic dusts (vegetable or animal) or to chemicals, except for cosmetics and cleaning products. Estimation of incidences by the occupational health services showed a different pattern in different sectors of activity. The methods for detecting emerging diseases are presented and illustrated by the example of systemic sclerosis, identifying new exposures and new sectors of activity to be investigated.
Conclusion: The RNV3P collects data from two complementary samples: 30 university hospital centres (workers or former workers) and an occupational health service (current workers). This dual approach is useful for surveillance and for hypothesis generation on new emerging disease-exposure associations.
