Improving the assessment of occupational diseases by occupational physicians.
BACKGROUND
The prevention of occupational diseases is limited by a lack of insight into occupational exposure to risk. We developed a six-step approach to improve the diagnosis and reporting of occupational diseases and the selection of subsequent preventive actions by occupational physicians (OPs).


OBJECTIVE
To evaluate the effect of the six-step approach on the transparency and quality of assessing occupational diseases and the usability of the six-step approach according to OPs and their satisfaction with it.


METHODS
A randomized controlled trial. OPs in the control group used the standard information available. OPs in the intervention group used the six-step approach and accompanying educational materials. The actions and decisions of OPs in both groups were analysed using 17 performance indicators. To address the second issue, OPs used the six-step approach over 6 weeks and rated its usability and their satisfaction in relation to several aspects.


RESULTS
The average score of the OPs in the intervention group (n = 110) was statistically significantly higher (11/17 performance indicators, 62% of the maximum score) than that of the OPs in the control group (n = 120, 5/17 performance indicators, 30% of the maximum score, P < 0.001). The usability aspects of the six-step approach had mean scores of 7 and 8. Mean satisfaction with the six-step approach was 8.


CONCLUSIONS
The six-step approach resulted in better evidence-based and transparent decision-making about occupational diseases by OPs. Usability and satisfaction were rated as satisfactory by the OPs.
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands, j.s.boschman@amc.nl.
J S
JS
Boschman
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Netherlands Center for Occupational Diseases, 1100 DD Amsterdam, The Netherlands.
T
T
Brand
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands.
M H W
MH
Frings-Dresen
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands.|Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Netherlands Center for Occupational Diseases, 1100 DD Amsterdam, The Netherlands.
H F
HF
van der Molen
D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D020380:Needs Assessment / Q000592:standards*; D009784:Occupational Diseases / Q000175:diagnosis*; D009787:Occupational Medicine / Q000193:education* / Q000592:standards; D000078329:Workforce
Decision-making; occupational diseases; randomized controlled trial.