Search

Rapid changes in working conditions constantly give rise to new occupational health risks and work-related diseases (WRDs). Monitoring these new WRDs is essential from the aspects of early recognition and prevention. In addition, it requires a comprehensive approach, using several complementary methods. One of these methods are early warning systems designed to collect information on health effects in order to trigger interventions and prevention. These systems differ in characteristics, their ability to capture new WRDs and their link with prevention. Therefore, the aim of this study is to identify sentinel and alert systems for detecting new and emerging WRDs, describe their main characteristics, and set up a basic typology. In the first phase, we conducted an extensive scientific and grey literature review and we identified 75 surveillance systems covering 26 different countries. We set up a basic typology of these systems dividing them into four main groups: compensation-based systems (21), non-compensation related comprehensive systems (38), sentinel systems (12) and public health surveillance systems aimed at workers and non-workers (7). These systems further differed in type of WRDs, coverage, data collection, evaluation of work-relatedness; follow up of new/emerging risks, link with prevention etc. In the second phase, we chose a representative selection of 12 good practise examples to be described in-depth. Through a desk research and interviews with stakeholders, we gained additional insight into drivers and obstacles regarding these systems and usage of collected data for identification of WRDs, prevention and policy recommendations.

Objectives Drawing on a literature review on sentinel and alert systems for identifying new/emerging work-related diseases (WRDs) a basic typology of systems was developed. These systems differ in characteristics, ability to capture new WRDs and link with prevention. The objectives of the subsequent study of a subset of systems were to describe in-depth aims, drivers and obstacles of the systems and use of their data in practice, for prevention and detecting new/emerging WRDs. Methods Twelve systems were chosen reflecting the different types (linked to compensation or not, aimed at all WRDs or a subset of diseases, sentinel systems, workers only or general public). Six systems were described based on desk research and six other systems were studied through interviews with different actors to gather information on the operation of the systems and the use of the gathered data for prevention. Results Several important themes emerged from the comparative tables, related to the design and performance of the system: visibility, reporting methods, exposure assessment, data quality, linkage to other institutions, and related to data use for prevention, alert on hazardous situations, awareness on new/emerging diseases. Conclusions Each system has its strengths and limitations, closely related to its purpose and the country that developed it. Sentinel systems seem to be best equipped for prevention and alert on new/emerging diseases. Enhancing reporting needs to balance required information and perceived reward for reporters. Embedding of systems in governmental or public health organisations is important in terms of financing, expertise and dissemination of results.