A nationwide fullweb access database for occupational disease prevention and Vigilance: the Rnv3p System

Introduction
Surveillance and prevention of adverse health effects of occupational exposures is a complex task in a context of rapid industrial processes evolution. That is why occupational physicians as well as searchers have to share their knowledge and hypotheses in real time. To respond to these challenges, the French Agency Anses and the French National Network for Monitoring and Prevention of Occupational Diseases (RNV3P) have made up a new nationwide fullweb database.

Methods
This network is constituted by the 32 occupational disease departments located in French University Hospitals, where patients with suspected work-related disease are referred to for examination and diagnosis. The innovative system is a fullweb access database. All the previous cases (>100 000 recorded with the previous network) have been imported in the new system.

Results
The new database includes 5 main modules: recording and requiring functions, quality controls and statistics, automatic reports, related questionnaires, and communication tools. The quality of the data is optimised by the use of a computerised tool for monitoring the information coherence, by annual training in quality assurance for users and by a national coding group as well as by centralised quality controls. Recorded information includes clinical data as main diagnosis and co-morbid diseases (ICD-10 code), main occupational exposure and four possible agents (national exposure thesaurus), occupation (ISCO-88) and sector of occupational activity (NAF code). The strength of the association between a disease and each suspected causal agent is rated by the medical expert according to a toxicovigilance-based method.

Discussion
As far as we know, the RNV3P is the first fullweb nationwide system used as a vigilance and prevention tool for occupational diseases. This system will permit to conduct surveillance actions and search projects to improve prevention with early reactivity. The web nature of the system also aims to work cooperatively with our European partners.