Occupational sentinel health events: An up‐dated list for physician recognition and public health surveillance

Abstract

An occupational sentinel health event (SHE[O]) is a disease, disability, or untimely death, which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. Following survey of scientific literature, a list of 50 disease conditions linked to the workplace was presented in 1983; these were codable within the framework of the International Classification of Diseases system (ICD-9). Three criteria were used for inclusion: documentation of associated agent(s), of involved industries, and of involved occupations. The up-dated list contains 64 diseases or conditions and a bibliography of literature citations. The list is useful for the practicing physician in occupational disease recognition, for occupational morbidity and mortality surveillance, and as a periodically up-dated database of occupationally related diseases.

Canadian Thoracic Society Guidelines for Occupational Asthma

“…The patient with OA should be considered to represent a 'sentinel event' (52) in the workplace. Consideration should be given to the possibility of OA in other exposed workers and measures should be taken where possible to reduce this risk by changes in work process, containment or ventilation improvements.…”

Metalworking fluid-associated hypersensitivity pneumonitis: A workshop summary

“…A single case of physician-diagnosed HP should trigger active surveillance, on the assumption that such a case is a sentinel event for coworkers at risk [Rutstein et al, 1983;Mullan and Murthy, 1991].…”

Evaluación del programa de Vigilancia Epidemiológica en Salud laboral: Red de Médicos Centinela de Salud Laboral en Navarra (1998-2007)

“…Los sucesos centinela notificados por el médico de atención primaria se consideran como laborales, cuando es confirmado por parte de un médico especialista en medicina del trabajo del INSL que, a partir de la investigación de los casos que han dado su consentimiento (casos nominales) y que se ha podido completar el estudio, los ratifica como de posible origen laboral (criterio basado en la lista de Mullan y Murphy de 1991 10 ). El otro gran indicador que se calcula para la evaluación del Programa es el valor predictivo positivo, porcentaje de sucesos centinela que son confirmados posteriormente como de posible origen laboral por un médico del trabajo respecto al total de sucesos notificados.…”

“…Lo definió como "una enfermedad, discapacidad, o muerte evitable, asociada a una ocupación y cuya aparición debe: 1) motivar el inicio de estudios epidemiológicos o de higiene industrial o 2) servir de señal de alarma para sustitución de materiales, control de instalaciones, uso de protección personal o necesidad de atención sanitaria. Para el programa se eligieron 5 patologías a vigilar de la lista de Mullan y Murphy de 1991 10 que son: Tendinitis de EESS (codo y muñeca), Síndrome del túnel carpiano (STC), Asma ocupacional, Síndrome de disfunción reactiva vías aéreas (RADS y Dermatitis profesional.…”