Progress in Prevention of Occupational Skin Dieseases – Medical, Regulatory and Societal Aspects – Occupational dermatoses: disease burden and options of prevention from an insurer´s point of view

Prevention of occupational dermatoses is of great importance and is achieved in different ways, e.g. education, improved skin care methods, protective equipment, early dermatological intervention etc. To effectively combine the necessary efforts maybe hampered by lacking legal prerequisites and insufficient financial funding. It is a specificity of the German legal system, that a particular branch of the social insurance is responsible for occupational accidents and diseases; responsibilities comprise surveillance of prevention in the workplaces as well as cost-coverage of all medical treatment for occupational illnesses, job retraining and compensation benefits. In order to reduce disease burden and resulting costs, the statutory employers’ liability insurances (which are further subdivided by branches) in the last decade have supported extensive research and development of a multi-step approach from primary to tertiary prevention to avoid occupational skin diseases and job loss for this reason. The scope of activities was initially focused on the hairdressers’ trade and the health-sector, and was then gradually extended to all risk-professions.  In the framework of this new preventive initiative dermatological consultations were facilitated, special nationwide expert teaching centers for dermatological and health-educational intervention (“schu.ber.z”) were set up, offering specifically designed practical courses for various risk-professions at a very early stage of occupational dermatoses(incl. allergic contact dermatitis). This has led to a marked reduction of incidence and prevalence of occupational dermatoses in risk-professions like the hairdressers’ trade and the health sector. In these latter professions, the reduction in the expenses of the BGW for rehabilitation payments caused by occupational skin diseases in the last decade is remarkable: 48,2 Mio €/1994 to 17,3 Mio €/2010. Our figures prove that combined interdisciplinary preventive efforts can be very efficient not only in terms of reducing disease burden in individuals but also the economic burden for society by occupational diseases.