Orriols R, Costa R, Albanell M, Alberti C, Castejon J, Monso E, Panades R, Rubira N, Zock J-P
Societat Catalana de Pneumologia, Catalonia, Spain.
Occup Environ Med. 2006 Apr;63(4):255-60. doi: 10.1136/oem.2005.022525.
A voluntary surveillance system was implemented in Catalonia (Spain) to ascertain the feasibility, incidence, and characteristics of occupational respiratory diseases and compare them with those of the compulsory official system.
In 2002, in collaboration with the Occupational and Thoracic Societies of Catalonia, occupational and chest physicians and other specialists were invited to report, on a bimonthly basis, newly diagnosed cases of occupational respiratory diseases. Information requested on each case included diagnosis, age, sex, place of residence, occupation, suspected agent, and physician's opinion on the likelihood that the condition was work related. Compulsory official system data derived from statistics on work related diseases for possible disability benefits declared by insurance companies, which are responsible for declaring these diseases to the Autonomous Government of Catalonia.
Of 142 physicians seeing patients with occupational respiratory diseases approached, 102 (74%) participated. Three hundred and fifty nine cases were reported, of which asthma (48.5%), asbestos related diseases (14.5%), and acute inhalations (12.8%) were the most common. Physicians rated 63% of suspected cases as highly likely, 28% as likely, and 8% as low likelihood. The most frequent suspected agents reported for asthma were isocyanates (15.5%), persulphates (12.1%), and cleaning products (8.6%). Mesothelioma (5.9%) was the most frequent diagnosis among asbestos related diseases. The number of acute inhalations reported was high, with metal industries (26%), cleaning services (22%), and chemical industries (13%) being the most frequently involved. The frequency of occupational respiratory diseases recorded by this voluntary surveillance system was four times higher than that reported by the compulsory official system.
The compulsory scheme for reporting occupational lung diseases is seriously underreporting in Catalonia. A surveillance programme based on voluntary reporting by physicians may provide better understanding of the incidence and characteristics of these diseases. Persulphates and cleaning products, besides isocyanates, were the most reported causes of occupational asthma. Metal industries and cleaning services were the occupations most frequently involved in acute inhalations with a remarkably high incidence in our register.
在加泰罗尼亚（西班牙）实施了一项自愿监测系统，以确定职业性呼吸系统疾病的可行性、发病率和特征，并将其与强制性官方系统的情况进行比较。
2002年，与加泰罗尼亚职业与胸科学会合作，邀请职业和胸部科医生及其他专家每两个月报告新诊断的职业性呼吸系统疾病病例。每个病例所需的信息包括诊断、年龄、性别、居住地点、职业、疑似致病因子以及医生对该疾病与工作相关性可能性的意见。强制性官方系统的数据来自保险公司申报的可能获得残疾福利的与工作相关疾病的统计数据，保险公司负责向加泰罗尼亚自治区政府申报这些疾病。
在142名诊治职业性呼吸系统疾病患者的医生中，102名（74%）参与了调查。共报告了359例病例，其中哮喘（48.5%）、石棉相关疾病（14.5%）和急性吸入性疾病（12.8%）最为常见。医生将63%的疑似病例评为高度可能，28%为可能，8%为低可能性。哮喘最常报告的疑似致病因子是异氰酸酯（15.5%）、过硫酸盐（12.1%）和清洁产品（8.6%）。间皮瘤（5.9%）是石棉相关疾病中最常见的诊断。报告的急性吸入性疾病数量较多，金属行业（26%）、清洁服务行业（22%）和化学行业（13%）是最常涉及的行业。该自愿监测系统记录的职业性呼吸系统疾病发病率比强制性官方系统报告的高出四倍。
加泰罗尼亚职业性肺病的强制性报告计划存在严重漏报情况。基于医生自愿报告的监测计划可能有助于更好地了解这些疾病的发病率和特征。除异氰酸酯外，过硫酸盐和清洁产品是职业性哮喘最常报告的病因。金属行业和清洁服务行业是急性吸入性疾病最常涉及且在我们的登记中发病率极高的职业。
