title: An integrated comprehensive occupational surveillance system for health care workers.
abstract: BACKGROUND
  Workers in the health care industry may be exposed to a variety of work-related stressors including infectious, chemical, and physical agents; ergonomic hazards; psychological hazards; and workplace violence. Many of these hazards lack surveillance systems to evaluate exposures and health outcomes. The development and implementation of a comprehensive surveillance system within the Duke University Health System (DUHS) that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of health care workers (HCWs) is presented.
  
  
  METHODS
  Human resources job and work location data were used to define the DUHS population at risk. Outcomes and exposure data from existing occupational health and safety programs, health promotion programs, and employee health insurance claims, were linked with human resources data and de-identified to create the Duke Health and Safety Surveillance System (DHSSS).
  
  
  RESULTS
  The surveillance system is described and four examples are presented demonstrating how the system has successfully been used to study consequences of work-related stress, hearing conservation program evaluation, risk factors for back pain and inflammation, and exposures to blood and body fluids (BBF).
  
  
  CONCLUSIONS
  Utilization of existing data, often collected for other purposes, can be successfully integrated and used for occupational health surveillance monitoring of HCWs. Use of the DHSSS for etiologic studies, benchmarking, and intervention program evaluation are discussed.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27705, USA. john.dement@duke.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Dement
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Pompeii
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.forename: Carol
authors.initials: C
authors.lastname: Epling
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.forename: Tamara
authors.initials: T
authors.lastname: James
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.forename: George
authors.initials: G
authors.lastname: Jackson
authors.forename: Wayne
authors.initials: W
authors.lastname: Thomann
mesh_terms: D006282:Health Personnel; D006285:Health Planning; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D016272:Occupational Health; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology