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14 February 2019

Detecting work-related diseases using alert and sentinel systems: a report of the European Agency for Safety and Health at work

A report of the European Agency for Safety and Health at work (EU-OSHA) analyses the alert and sentinel systems used in various European countries for the early detection of work-related diseases. This report is based on the analysis of twelve national schemes implemented in European countries or the United States, all of which help to spotlight health problems caused by bad working conditions and insufficient prevention measures in companies.

In all European countries, recognised and compensated work-related diseases account for just a small fraction of health problems caused by work. This situation concerns both risks known for many generations and new risks associated with the use of new processes, with changes in work organisation and with the use of chemical substances whose risks have not been properly assessed. In many countries, the covering-up of work-related diseases applies more to women than to men and is particularly striking in the field of cancers where very few women workers manage to get their cancer recognised as having been caused by work.

Examples include the ‘popcorn disease’, a serious lung disease in factory workers, and heart problems from carbon monoxide exposure at a coffee-processing plant.

The report identified 75 surveillance systems used in 26 countries. In-depth analysis on 12 of the systems shows the different approaches that can be followed and showcases their strength and versatility. Practical aspects of their implementation and links with prevention and policy-making are described and the report also shows how an alert and sentinel function can be added to an existing monitoring system.

The key findings also reflect on the following issues:

  • There is no ideal surveillance system. Several systems are described, each with strong points and disadvantages. Stakeholders should consider the context in which the system will operate, learn from good practice examples and aim to implement approaches that complement those already in place.
  • Some monitoring gaps were identified. Specific groups of work-related diseases, in particular multifactorial and long-latency work-related diseases such as mental illnesses, musculoskeletal disorders and certain cancers, or the potential health effects of new and emerging technologies such as nanotechnologies or advanced robotics, are not currently well monitored. In addition, the focus tends to be on traditional sectors such as agriculture and construction and should be expanded to incorporate neglected sectors such as the hotel, restaurant and catering sector and growing sectors such as communication and IT services.
  • Important factors in developing these systems include sharing success stories about the contribution of these systems to the identification of new work-related diseases and their prevention. This is vital both to motivate people to report cases and to secure political and financial support. Strengthening collaboration with national OSH bodies, and with public health bodies, is also a key success factor to transfer the systems’ findings into policy-making. International cooperation and data sharing between Member States is important to improve alert and sentinel surveillance in the EU.

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