Update of Czech List of Occupational Diseases, does it reflect the reality?

Introduction
After 16 years, Czech List of Occupational Diseases (ODs) was updated in 2011 (order No. 114/2011). Czech mixed List is grouped into 6 chapters. 

Methods
Trends in ODs, reported to the National Registry of ODs were evaluated and the items on the Czech List of ODs were compared with the EC Recommendation (1) and the ILO List (2). 

Results
Reported ODs in the Czech Republic (population of 10 million) show a stable decreasing trend. The incidence in 2010 was 30/100,000 employees. Total number was 1,292 and dropped to 43.8% comparing with 1995. Any ODs can be acknowledged in open Chapters: Chemical agents, Infectious agents and Skin Diseases – the spectrum is even larger, than the EU List. All disorders of the Respiratory tract of EU List are included. However, following disorders, caused by Physical agents are missing: Avulsion due to overstraining of the spinous processes, and Disc-related diseases of the lumbar vertebral column caused by the repeated whole-body vibration. The ILO List enables to include any disorder, thanks to “free item” in every chapter. In Czech Republic, a “free” item to cover newly emerging disorders has been suggested by the Ministry of Social Affairs, but did not get sufficient support from other stakeholders.

Discussion
The number of pneumoconioses and intoxications dropped substantially, carpal tunnel syndrome was the most frequent disease (390 cases, 30.2%). Unfortunately, the decrease of ODs cannot be interpreted only positively. In addition to improved technical prevention, several factors play the role in the system - an increasing unemployment, migration of the workers and shortage of occupational physicians. The List of ODs in the Czech Republic will be updated every 2 years, so that newly emerging diseases could be included.

Acknowledgement: MSM 0021620807, IGA NS10298.

References: 1. Commission Recommendation 2003/670/EC, 2. ILO List of Occupational Diseases (2010).