[Role of specialized care services of the national health service in the new framework for the prevention of occupational risks (I)].
BACKGROUND
The Spanish constitution and other legal provisions reflect the need to guarantee the health and security of workers at work. The Prevention of Industrial Risks Act incorporates this mandate and suggests a new model of prevention based on continued control of risk, participation of the workers and their education, and different modes of prevention management are set out.


METHODS
The objective of occupational medicine covers four areas: environment (evaluation of posts, teams, dangerous substances, etc.), health (vigilance of professional illness), emergencies and information and documentation (confidentiality). At present the task of the occupational doctor is hampered by (a) The polarization of prevention: the effort to reduce the high rate of accidents and permissiveness with regard to professional illness. (b) Complementary investigations: the lack of specialist reference services which supervise the health of the workers. (c) Minimal development in small and medium size businesses: The National Health System phagocytes industrial diseases, erroneously labelled as ordinary illness.


CONCLUSIONS
(1) The medical training of all specialists should include a period dedicated to the study of occupational diseases and work as a source of health problems. (2) To improve the coordination between the occupational doctor and the Primary Care doctor, the creation of specialist reference services for occupational illnesses, by means of the National Health Service or the Mutual Aid Societies of occupational accidents and professional illnesses so as to refer suspected cases to them. (3) To emphasize the clinical history, evaluating the principle of Hipocrates. (4) To take into account sentry pathology in conditions of unknown origin. (5) To make a specific control of the health of all workers, particularly those who work with dangerous products or substances.
Goicoechea-Iribarren
J M
JM
Sociedad Española de Medicina y Seguridad del Trabajo, León XIII, 1-3, E-50008 Zaragoza.
D005544:Forecasting; D006801:Humans; D008511:Medicine; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D009784:Occupational Diseases / Q000517:prevention & control; D016272:Occupational Health / Q000331:legislation & jurisprudence*; D013030:Spain; D013038:Specialization