title: The impact of occupational health service network and reporting system in Taiwan.
abstract: BACKGROUND
  Underreporting occupational disease cases has been a long-standing problem in Taiwan, which hinders the progress in occupational health and safety. To address this problem, the government has founded the Network of Occupational Diseases and Injuries Service (NODIS) for occupational disease and injury services and established a new Internet-based reporting system.
  
  
  OBJECTIVE
  The aims of this study are to analyze the possible influence of the NODIS, comprised of Center for Occupational Disease and Injury Services and their local network hospitals, on compensable occupational diseases and describe the distribution of occupational diseases across occupations and industries from 2005 to 2010 in Taiwan.
  
  
  METHODS
  We conducted a secondary analysis of two datasets, including the NODIS reporting dataset and the National Labor Insurance scheme's dataset of compensated cases. For the NODIS dataset, demographics, disease distribution, and the time trends of occupational diseases were analyzed. The data of the Labor Insurance dataset was used to calculate the annual incidence of compensated cases. Furthermore, the annual incidence of reported occupational diseases from the NODIS was further compared with the annual incidence of compensable occupational diseases from the compensated dataset during the same period.
  
  
  RESULTS
  After the establishment of the NODIS, the two annual incidence rates of reported and compensable occupational disease cases have increased by 1.2 and 2.0 folds from 2007 to 2010, respectively. The reason for this increased reporting may be the implementation of the new government-funded Internet-based system. The reason for the increased compensable cases may be the increasing availability of hospitals and clinics to provide occupational health services. During the 2008-2010 period, the most frequently reported occupational diseases were carpal tunnel syndrome, lumbar disc disorder, upper limb musculoskeletal disorders, and contact dermatitis.
  
  
  CONCLUSIONS
  The new network and reporting system was successful in providing more occupational health services, providing more workers with compensation for occupational diseases, and reducing underreporting of occupational diseases. Therefore, the experience in Taiwan could serve as an example for other newly developed countries in a similar situation.
authors.affiliation: Environmental and Occupational Medicine, and Center for Occupational Diseases and Injuries Services, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan.
authors.forename: Po-Ching
authors.initials: PC
authors.lastname: Chu
authors.affiliation: Department of Labor Safety and Health, Council of Labor Affairs, Executive Yuan, Taiwan.
authors.forename: Hwan-Ran
authors.initials: HR
authors.lastname: Fuh
authors.affiliation: Center for Occupational Diseases and Injuries Services, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taiwan.
authors.forename: Jiin-Chyuan
authors.initials: JC
authors.lastname: Luo
authors.affiliation: Environmental and Occupational Medicine, and Center for Occupational Diseases and Injuries Services, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan.
authors.forename: Chung-Li
authors.initials: CL
authors.lastname: Du
authors.affiliation: Center for Occupational Diseases and Injuries Services, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chuang
authors.affiliation: Center for Occupational Diseases and Injuries Services, National Cheng Kung University Hospital, Taiwan.
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.affiliation: Center for Occupational Diseases and Injuries Services, China Medical University Hospital, Taiwan.
authors.forename: Chiu-Shong
authors.initials: CS
authors.lastname: Liu
authors.affiliation: Center for Occupational Diseases and Injuries Services, Taipei Medical University Hospital, Taiwan.
authors.forename: Chien-Tien
authors.initials: CT
authors.lastname: Su
authors.affiliation: Center for Occupational Diseases and Injuries Services, Changhua Christian Hospital, Taiwan.
authors.forename: Feng-Cheng
authors.initials: FC
authors.lastname: Tang
authors.affiliation: Center for Occupational Diseases and Injuries Services, Chung Shan Medical University Hospital, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Center for Occupational Diseases and Injuries Services, Hualien Medical Center, Buddhist Tzu Chi General Hospital, Taiwan.
authors.forename: Hsiao-Yu
authors.initials: HY
authors.lastname: Yang
authors.affiliation: Environmental and Occupational Medicine, and Center for Occupational Diseases and Injuries Services, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan.
authors.forename: Yue Leon
authors.initials: YL
authors.lastname: Guo
mesh_terms: D000328:Adult; D004282:Documentation; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D060051:Occupational Injuries / Q000453:epidemiology*; D009790:Occupations; D012308:Risk Management; D018571:Sentinel Surveillance; D013624:Taiwan; D014942:Workers' Compensation