title: Diagnosing and reporting of occupational diseases: a quality improvement study.
abstract: OBJECTIVE
  To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder.
  
  
  METHODS
  Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were sent to all occupational physicians recorded on the Netherlands Centre for Occupational Diseases database. The performance of responding occupational physicians was then assessed by separate scores per performance indicator and by a total quality score.
  
  
  RESULTS
  Twenty-three questionnaires on noise-induced occupational hearing loss and 125 questionnaires on occupational adjustment disorder were available for analysis. The mean quality score for diagnosing and reporting was 6.0 (SD: 1.4) for noise-induced occupational hearing loss and 7.9 (SD: 1.5) for occupational adjustment disorder on a scale of 0-10. For noise-induced occupational hearing loss, there was a need for quality improvement of the aspects of medical history, audiometric measurement, clinical diagnosis of the disease and reporting. For occupational adjustment disorder, the assessment of other non-occupational causes needed improvement.
  
  
  CONCLUSIONS
  The quality of diagnosing and reporting could be improved for noise-induced occupational hearing loss and occupational adjustment disorders. Information, education and practical tools are proposed for quality improvements.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, the Netherlands. d.spreeuwers@amc.uva.nl
authors.forename: D
authors.initials: D
authors.lastname: Spreeuwers
authors.forename: A G E M
authors.initials: AG
authors.lastname: de Boer
authors.forename: J H A M
authors.initials: JH
authors.lastname: Verbeek
authors.forename: M M
authors.initials: MM
authors.lastname: van Beurden
authors.forename: F J H
authors.initials: FJ
authors.lastname: van Dijk
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D005260:Female; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009623:Noise, Occupational / Q000009:adverse effects*; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care