A regional occupational medicine service: Qualitative and quantitative assessment

A quantitative description of a regional occupational medicine system, serving some 200,000 workers in a broad spectrum of occupations, is given. The main activities of the service - pre-employment, medical surveillance, and fitness-to-work examinations - are presented in quantitative terms. Approximately 27,000 examinations are performed annually, of which about 50% require biological monitoring for a specific occupational exposure, 35% are fitness-for-work examinations, and 15% are pre-employment examinations. The main abnormal findings identified by fitness examinations involved the musculoskeletal (25%), cardiovascular (13%), or upper respiratory, pulmonary, and neurologic systems (3% each). Among surveillance examinations, the most frequently identified pathology is phonal trauma (11%). The three types of examinations are looked at with respect to rates of abnormal findings over a one-year period, compared with the mean rate of abnormal findings over the preceding five-year period, and future trends are extrapolated. The implications regarding assessment of resource allocation, appropriate budgeting, and personnel recruitment and training, as well as planning of worker safety and health maintenance programs, are noted. The authors conclude that ongoing quantitative analysis of the activities of a regional occupational medicine service is mandatory for quality assurance and future planning responsive to the dynamic needs of the target workforce.