Chapter 32 - Record Systems and Surveillance.docxVIP专享VIP免费原创优质

Chapter32-RecordSystemsandSurveillanceOCCUPATIONALDISEASESURVEILLANCEANDREPORTINGSYSTEMSStevenB.MarkowitzOccupationaldiseaseandinjurysurveillanceentailsthesystematicmonitoringofhealtheventsinworkingpopulationsinordertopreventandcontroloccupationalhazardsandtheirassociateddiseasesandinjuries.Occupationaldiseaseandinjurysurveillancehasfouressentialcomponents(Baker,MeliusandMillar1988;Baker1986).1.Gatherinformationoncasesofoccupationaldiseasesandinjuries.2.Distilandanalysethedata.3.Disseminateorganizeddatatonecessaryparties,includingworkers,unions,employers,governmentalagenciesandthepublic.4.Interveneonthebasisofdatatoalterthefactorsthatproducedthesehealthevents.Surveillanceinoccupationalhealthhasbeenmoreconciselydescribedascounting,evaluatingandacting(Landrigan1989).Surveillancecommonlyreferstotwobroadsetsofactivitiesinoccupationalhealth.Publichealthsurveillancereferstoactivitiesundertakenbyfederal,stateorlocalgovernmentswithintheirrespectivejurisdictionstomonitorandtofollowuponoccupationaldiseasesandinjuries.Thistypeofsurveillanceisbasedonapopulation,thatis,theworkingpublic.Therecordedeventsaresuspectedorestablisheddiagnosesofoccupationalillnessandinjury.Thisarticlewillexaminetheseactivities.Medicalsurveillancereferstotheapplicationofmedicaltestsandprocedurestoindividualworkerswhomaybeatriskforoccupationalmorbidity,todeterminewhetheranoccupationaldisordermaybepresent.Medicalsurveillanceisgenerallybroadinscopeandrepresentsthefirststepinascertainingthepresenceofawork-relatedproblem.Ifanindividualorapopulationisexposedtoatoxinwithknowneffects,andifthetestsandproceduresarehighlytargetedtodetectthelikelypresenceofoneormoreeffectsinthesepersons,thenthissurveillanceactivityismoreaptlydescribedasmedicalscreening(HalperinandFrazier1985).Amedicalsurveillanceprogrammeappliestestsandproceduresonagroupofworkerswithcommonexposuresforthepurposeofidentifyingindividualswhomayhaveoccupationalillnessesandforthepurposeofdetectingpatternsofillnesswhichmaybeproducedbyoccupationalexposuresamongtheprogrammeparticipants.Suchaprogrammeisusuallyundertakenundertheauspicesoftheindividual’semployerorunion.FunctionsofOccupationalHealthSurveillanceForemostamongthepurposesofoccupationalhealthsurveillanceistoidentifytheincidenceandprevalenceofknownoccupationaldiseasesandinjuries.Gatheringdescriptiveepidemiologicaldataontheincidenceandprevalenceofthesediseasesonanaccurateandcomprehensivebasisisanessentialprerequisiteforestablishingarationalapproachtothecontrolofoccupationaldiseaseandinjury.Assessmentofthenature,magnitudeanddistributionofoccupationaldiseaseandinjuryinanygeographicarearequiresasoundepidemiologicaldatabase.Itisonlythroughanepidemiologicalassessmentofthedimensionsofoccupationaldiseasethatitsimportancerelativetootherpublichealthproblems,itsclaimforresourcesandtheurgencyoflegalstandardsettingcanbereasonablyevaluated.Second,thecollectionofincidenceandprevalencedataallowsanalysisoftrendsofoccupationaldiseaseandinjuryamongdifferentgroups,atdifferentplacesandduringdifferenttimeperiods.Detectingsuchtrendsisusefulfordeterminingcontrolandresearchprioritiesandstrategies,andforevaluatingtheeffectivenessofanyinterventionsundertaken(Baker,MeliusandMillar1988).Asecondbroadfunctionofoccupationalhealthsurveillanceistoidentifyindividualcasesofoccupationaldiseaseandinjuryinordertofindandevaluateotherindividua...