[Expert opinion on occupational skin diseases: a Munich statement regarding the Bamberg medical bulletin (Bamberger Merkblatt)].
The Bamberg medical bulletin (Bamberger Merkblatt) is intended to assure as an anticipated expert opinion an objective as possible assessment of the sequels of an occupational disease. However, the Bamberg medical bulletin is not suitable for this task in form and content. In case of an allergic contact dermatitis recognized under No. 51 01 in appendix 1 of the German ordinance on occupational diseases the disadvantage for the insured person consists mainly in the live-long existing change of the immune system and not as much in the intensity of the skin condition triggered by a new exposure to the allergen. The prerequisite for compensation imposed by the regulator, i.e. that the skin condition must be so severe as to have forced the affected individual to refrain from all activities which led or could lead to the development, aggravation or recurrence of the condition, is in its function as a typing sign widely unnecessary in the case of an allergic occupational dermatosis. The omission of all activities which led or could lead to the development, aggravation or recurrence of the condition imposed on the affected individual by the regulator has to be taken in account for the calculation of the reduction in earning capacity in the Bamberg medical bulletin. The Bamberg medical bulletin is by no means an anticipated expert opinion. Even as a qualified experience it urgently needs a revision which might be done with, but not governed by, the statutory occupational accident insurance. Our critical scientific comments do not absolve the medical evaluator from the responsibility to consider existing recommendations as the Bamberg medical bulletin. Our aim is to initiate a process leading to an appropriate judgement of the sequels of an occupational skin disease in each individual case.
Breit
Reinhard
R
Klinik für Dermatologie, Allergologie und Umweltmedizin, Klinikum Schwabing, Städtisches Klinikum München, Munich, Germany. reinhard.breit@gmx.de
Orgler
Meinhard
M
Plewig
Gerd
G
Ring
Johannes
J
Stolz
Wilhelm
W
Przybilla
Bernhard
B
D009783:Dermatitis, Occupational / Q000145:classification* / Q000175:diagnosis*; D003880:Dermatology / Q000592:standards*; D004185:Disability Evaluation; D005858:Germany; D006801:Humans; D017410:Practice Guidelines as Topic