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Studies suggest strong underreporting of occupational diseases (ODs) in industrialized countries. Although Dutch occupational physicians (OPs) are legally obliged to report ODs, there is considerable and growing underreporting in the national registry. Since 2005 there have been major changes in the way Occupational Health and Safety (OSH) is organized in the Netherlands. We aimed to identify OPs' views on how these changes may have affected the reporting of ODs.
Methods
We conducted a questionnaire-based descriptive study among OPs (n=1773) registered with the Netherlands Center for Occupational Diseases. OPs were asked to rate their opinion on a set of predefined and theoretically based statements on 1] reporting of ODs in general, 2] possible reasons for decreased reporting since 2005, and 3] barriers and facilitators for reporting in their own work setting.
Results
Five hundred and sixty-two OPs participated (32%) in the survey. They identified increased barriers in the contact between workers and OPs, because of changes in the Dutch OSH legislation and the way OSH services are organized since 2005. Those OPs working in OSH had to deal with an increased work load, partly due to budget cuts, and the number of self-employed increased. In their work settings, the focus was on ‘return to work’ activities rather than on prevention. Although OPs mentioned several barriers in recognizing and reporting ODs, those who report ODs seemed to be motivated mainly intrinsically, by their professionalism and increasing knowledge, rather than by more extrinsic ‘carrots and sticks’.
Discussion
A number of remedial approaches are proposed, including enhanced professional education, relevant knowledge transfer, simple electronic reporting, and the development of registration guidelines. Nevertheless improvement calls for a collaborative effort of all responsible parties and warrants further research to guide policy and practice.