Detection of new emerging diseases in occupational health

Introduction
In Belgium, law prescribes periodic health surveillance for employees exposed to occupational risks, including annual medical examinations. The non-profit organization IDEWE is the largest Belgian occupational health service providing service to 35.400 employers and 640.300 employees. Data from consultations (hazards, medical observations, etc.) are recorded and coded using international or national classifications. The aim of this project was to mine these data and generate hypotheses on new emerging occupational diseases by identifying groups of occupational health problems (OHP) with common exposure(s) using the technique of exposomes.

Methods
This procedure was tested on data from one organization obtained in 2010. The responsible health physician was trained to collect and recode data into the electronic medical file, e.g. demographic characteristics (i.e. age, gender), lifestyle factors (i.e. smoking, Body Mass Index, physical activity and blood pressure), reasons disease-absenteeism (ICD-9-CM), hazards (IDEWE-code), occupation (ISCO-code), activity sector (NACE-code) and current medication use. Data were analyzed descriptively and displayed graphically as a network linking OHP’s sharing at least three exposures. An OHP was defined as a unique combination of 1 pathology and exposure(s).

Results
The selected organization (NACE-code: 86101) represents data of 820 employees (85% women, mean age: 38.6 years). The most frequently reported reason for disease-absenteeism “ICD-460 (i.e. nasopharyngitis)” (n=22) was used to build the pilot-exposome. The number of exposures attributed to these employees ranged from 1 to 8. The pilot-exposome contained 22 unique OHP’s, showing 1 group of OHP’s (n=17) with common exposures (≥3) and 5 isolated OHP‘s.

Discussion
Only 1 exposure-group was identified, probably due to the lack of variability in attributed exposures and the characteristics of the selected disease. However, the idewe data can be considered suitable for this technique of exposomes. Further analysis will be performed on the total IDEWE-database, allowing us to mine data from different organizations and more than 200.000 employees.