There is insufficient evidence to advise for or against the use of drug and alcohol testing of occupational drivers for preventing injuries as a sole, effective, long-term solution in the context of workplace culture, peer interaction and other local factors. Cluster-randomised trials are needed to better address the effects of interventions for injury prevention in this occupational setting.

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There is a marked variation in postgraduate training in OM throughout UEMS countries. The variation between postgraduate training programmes is not consistent with UEMS charter requirements and because of national regulation purposes presents a barrier to the movement of migrant professionals within Europe. This study serves as a focus for further research into training routes and standards of specialization in OM in Europe.

Background In the 1990s, challenges were identified in relation to the quality of practice in occupational medicine, including a limited evidence-base and the need to translate good evidence into high-quality practice. Audit has been identified as having an important role to play in addressing the determinants of variations and quality in practice. Aims To explore current practice of occupational health (OH) audit and outcome measures. Methods A survey of 30 OH conference participants who were affiliated with an OH service or a professional body, from ~2000 attendees at the Triennial Congress of the International Commission on Occupational Health (ICOH) in Dublin, Ireland, over 2 days in May 2018. Results Of the 30 participants, 1 was lost at follow-up and 29 participants gave verbal consent to answer questions in relation to carrying out audit and outcomes. Overall, 25 participants undertook regular audit, 19 on an annual basis, 4 on a monthly basis and 2 every 2 years. Twelve participants confirmed multiple audit outcomes and 13 used audits for internal training purposes only. Four participants did not undertake any audit. Less than 50% confirmed multiple audit outcomes that included internal feedback for training purposes and external publication such as conference poster presentations and peer-reviewed publications. Conclusions This limited observational study underscores conclusions of previous research that development of clinical audit guidance and measurement of outcomes in occupational medicine is mostly unpublished.

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