One of the current gaps in the prevention of work-related diseases (WRDs) is the missing link between the assessment of occupational hazards introduced at the workplace, clinical alerts, epidemiological studies and policy actions. Alert systems aim to bridge this gap, by collecting information on diseases and exposures to raise alerts to different stakeholders and trigger timely prevention.

This project started with a review of international alert systems to identifying good practices and learning about prerequisites, drivers and obstacles to implement alert and sentinel systems. Next, the findings led to the implementation of an integrated approach consisting of alert systems on three levels in the Belgian context:

1. Signal detection and assessment: suspected clinical cases of new WRDs (new exposure–disease combinations) can be reported though an online platform called ‘SIGNAAL’. Each reported case is followed by an extensive assessment of exposure– and work–relatedness performed by clinical experts. Since the start, 22 cases have been reported to the platform.

2. Signal strengthening though a network of occupational health physicians. This sentinel approach has been introduced though the PROBE system, in which 47 occupational physicians participated. During the periodic health examinations of workers, the physicians filled in a web survey regarding occupational exposure of a random sample of workers to 22 selected hazardous chemicals during the last working week. Results of the first study showed that 47% of workers were exposed to at least one chemical product from the list, with diesel exhaust being the most frequently reported substance (n=91; 14% of workers).

3. Alerts to public health authorities are mainly communicated though collaboration with Federal Public Services and Federal Agency for Occupational Risks.

These agencies provide support in the maintenance of systems and in turn, data from the systems is used as input for potential preventive strategies on company and societal level.