[Four years of quality assurance of dermatologic procedures: report from the ABD clearing institution].
BACKGROUND
Expert dermatologic evaluation is the most relevant tool for secondary prevention in occupational dermatology in Germany. If there is a possibility of a work-related skin disorder in an employee, dermatologists may conduct the relevant diagnostic procedures (e.g. patch-and prick-tests, serology) at the expenses of the public employers' liability insurance fund (UVT). Most dermatologists make careful use of this unparalleled privilege, which is also an obligation. However, recently, with an increasing number of dermatologist's reports submitted, there have been occasional complaints by the UVT concerning overly extensive testing. In 1999 the Task Force on Occupational and Environmental Dermatology (ABD) of the German Dermatological Society established a clearing procedure. Two experienced occupational dermatologists will--separately--give their expert opinion on dermatologist's reports which have been forwarded anonymously by the UVT for expert review.


RESULTS
Thus far, from May 1999 to May 2003 155 dermatologist's reports have been submitted to the clearing procedure. The complaints were in > 95% of cases considered justified by the experts. Their criticism was primarily directed towards excessive testing procedures and failure to provide sufficient clinical information.


CONCLUSIONS
The UVT does not undertake such extensive preventive efforts for any other occupational disease. Therefore, quality management of the dermatologist's procedure--conducted by dermatologists and providing transparency--is essential to maintain and develop this effective tool of secondary prevention for the benefit of workers and employers.
John
Swen Malte
SM
Fachgebiet Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück. sjohn@uos.de
Diepgen
Thomas L
TL
Elsner
Peter
P
Köllner
Arno
A
Richter
Gerhard
G
Rothe
Axel
A
Schindera
Ingo
I
Stary
Alois
A
Wehrmann
Wolfgang
W
Schwanitz
Hans Joachim
HJ
D005858:Germany / Q000453:epidemiology; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012871:Skin Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome