Physicians' beliefs in the assessment of work attribution when reporting musculoskeletal disorders

Abstract

There was a strong agreement between occupational physicians and rheumatologists on questions about work-relatedness and musculoskeletal disorders. The level of probability for concluding work-relatedness has been quantified.

The incidence of occupational skin disease as reported to The Health and Occupation Reporting (THOR) network between 2002 and 2005

“…As many physicians reporting occupational dermatoses to EPIDERM and OPRA may not have access to patch‐testing facilities, their attitudes and beliefs are likely to have a substantial effect on reporting patterns. Such factors have been investigated for musculoskeletal reporting of occupational ill‐health within THOR where, despite the lack of strict criteria for case definition, there was strong agreement between rheumatologists and occupational physicians on work relatedness and work attribution 14 . However, these results (albeit encouraging) cannot be transferred directly from occupational musculoskeletal disease to occupational skin disease reporting.…”

“…Conclusions Information produced by THOR is an important source for calculating incidence rates of occupational skin disease. A range of reporting groups should also be used when building an overall picture of occupational skin disease incidence in the U.K. In 2004In -2005, an estimated 29 000 (95% confidence interval 21 000-37 000) people in Great Britain had self-reported skin problems that were caused or made worse by their current or past work. 1 These prevalence data are from the 2004 ⁄05 Self-reported Work-related Illness Survey, which reports information that is subjective, and dependent on the perceptions and beliefs of the sufferer.…”

Self-reported versus expert-assessed work-relatedness of pain in the neck, shoulder, and arm

“…If the aim is to prevent work-related illness, a wide definition may be preferable in order to prevent as much illness as possible (10,11). The World Health Organization defines work-related diseases as multifactorial diseases, in which "the work environment and the performance of work contribute significantly, but as one of a number of factors to the causation" of the disease (page 9, 12).…”

“…The World Health Organization defines work-related diseases as multifactorial diseases, in which "the work environment and the performance of work contribute significantly, but as one of a number of factors to the causation" of the disease (page 9, 12). For compensation purposes, a narrower definition is commonly used (11,13). In order to be included in the British scheduled list of prescribed occupational diseases, a disease must "more likely than not" be caused by work, defined as a (more than) doubling of risk for a person in a particular job compared to someone not in that occupation (page 9, 13).…”

“…These disorders are often chronic or recurrent, and are commonly associated with hazards both at and away from work. Clinical assessment of workrelatedness may, therefore, be particularly difficult (11). However, a group of European experts (10) has developed evidence-or consensus-based criteria for evaluating the work-relatedness of upper extremity musculoskeletal disorders (MSD); these criteria have been used in epidemiological studies (16,17) and by occupational physicians in the Netherlands (18).…”