title: Sentinel surveillance of occupational diseases: a quality improvement project.
abstract: BACKGROUND
  Occupational diseases are generally underreported. The aim of this study was to evaluate whether a sentinel surveillance project comprising motivated and guided occupational physicians would provide higher quality information than a national registry for a policy to prevent occupational diseases.
  
  
  METHODS
  A group of 45 occupational physicians participated in a sentinel surveillance project for two years. All other occupational physicians (N = 1,729) in the national registry were the reference group. We compared the number of notifications per occupational physician, the proportion of incorrect notifications, and the overall reported incidence of occupational diseases.
  
  
  RESULTS
  The median number of notifications per occupational physician during the project was 13.0 (IQR, 4.5-31.5) in the sentinel group versus 1.0 (IQR, 0.0-5.0) in the reference group (P < 0.001). The proportion of incorrect notifications was 3.3% in the sentinel group and 8.9% in the reference group (P < 0.001). The overall reported occupational disease incidence was 7 times higher (RR = 6.9, 95% CI: 6.5-7.4) in the sentinel group (466 notifications per 100,000 employee years) than in the reference group (67 notifications per 100,000 employee years).
  
  
  CONCLUSIONS
  A sentinel surveillance group comprising motivated and guided occupational physicians reported a substantially higher occupational disease incidence and a lower proportion of incorrect notifications than a national registry.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, 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: N S
authors.initials: NS
authors.lastname: de Wilde
authors.forename: I
authors.initials: I
authors.lastname: Braam
authors.forename: Y
authors.initials: Y
authors.lastname: Willemse
authors.forename: T M
authors.initials: TM
authors.lastname: Pal
authors.forename: F J H
authors.initials: FJ
authors.lastname: van Dijk
mesh_terms: D018563:Disease Notification / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D009426:Netherlands / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D009787:Occupational Medicine; D009790:Occupations; D010820:Physicians; D012042:Registries; D018571:Sentinel Surveillance; D017749:Total Quality Management