Introduction Different systems and methodological approaches have been developed internationally for the early identification of new and emerging occupational risks as well as for the monitoring of work related diseases. In Spain, a variety of them have been implemented at national and regional levels. This study is not only aimed to provide an up to date comprehensive perspective of all of them, but also to identify current challenges and barriers in their practical implementation and potential solutions.

Methods Literature review and in-depth description of existing systems at local and National levels in Spain through interviews of National experts (n=17) and qualitative analysis. Adding to that, professionals involved in those systems were invited to complete a questionnaire (participants: General Practitioners, Medical Doctors from the Spanish National Health System, Occupational Physicians, experts and Occupational Health workers from Mutual Societies and private companies; n=306).

Results Spanish existing systems at National and local levels are described and compared. The exception to the regional fragmentation is the nationwide system of epidemiological health surveillance of workers exposed to asbestos. Furthermore, one of the main limitations to the early identification of new and emerging occupational risks is the lack of dissemination of the existence of these systems among professionals responsible for the Occupational Health within private companies. In fact, only 36% of these professionals have been informed on them and 45,1% stated to be aware of Occupational Diseases notification systems. Another challenge to overcome is the poor communication between private companies and the public health system.

Discussion This study adds the Spanish perspective to an issue that is being deeply measured in Europe, and possibly pointing towards the need of promoting integrative approaches that involve Health and Work Administration and private firms, etc., in Early Detection of New and Emerging Occupational Risks.