Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany.
J Occup Med Toxicol. 2009 Nov 18;4:28. doi: 10.1186/1745-6673-4-28.
As a consequence of the disintegration of the state systems and the expansion of the European Union, there have been marked changes in the political and social affiliations of the countries of Eastern Europe. Of the 22 countries in Northeastern, Centraleastern, Southeastern and Eastern Europe, 12 are now members and 10 are "new" neighbours of the European Union. The accident insurance systems and changes in occupational accidents and occupational diseases in eastern European countries are described. Changes since EU and visible differences from non-EU countries are analysed. Special emphasis is given to occupational skin diseases.
The available data from the European Union (MISSOC and MISSCEEC Studies on the Social Protection Systems), the database "Social Security Worldwide" (SSW) of the International Social Security Association (ISSA), the International Labour Office Database (LABORSTA), the World Health Organization (WHO) and the annual statistical reports of the different countries were analysed with respect to changes in occupational accidents and occupational diseases. To find missing data, 128 ministries and authorities in the 22 countries in eastern Europe were researched and 165 persons contacted.
The social insurance systems were very different in the different countries and some were better established than others. Moreover, not all data were available. For these reasons, detailed comparison was not always possible. The occupational accident rates are decreasing in more than half the countries. In contrast, the fatal accident rates have increased in half the countries. The number of newly registered occupational diseases is decreasing in more than half the countries. The rates for occupational skin diseases in 2006 were particularly high in the Czech Republic, Poland and Slovakia. In half the countries (four out of eight), the number of occupational skin diseases is decreasing. A reliable analysis of any correlation between EU membership and the rates of occupational accidents and occupational diseases was not possible, because of missing current data.
Comparison of the social insurance systems and changes in occupational accidents and occupational diseases in 22 countries in eastern Europe makes it clear that further effort is needed to develop registration and notification procedures. Only then will it be possible to analyse changes, to map successes and problems and perhaps to initiate necessary improvements. Standardisation of the documents must also be improved, to allow international comparisons between the systems.
随着国家体系的解体和欧盟的扩张，东欧国家的政治和社会关系发生了显著变化。在东北、中东欧、东南欧和东欧的 22 个国家中，有 12 个现在是欧盟成员国，10 个是欧盟的“新”邻国。本文描述了东欧国家意外保险制度的变化和职业事故及职业病的变化。分析了自欧盟以来的变化以及与非欧盟国家的明显差异。特别强调了职业性皮肤病。
利用来自欧盟的可用数据（MISSOC 和 MISSCEEC 社会保护制度研究）、国际社会保障协会（ISSA）的“全球社会保障数据库”（SSW）、国际劳工组织数据库（LABORSTA）、世界卫生组织（WHO）以及不同国家的年度统计报告，分析了职业事故和职业病的变化。为了找到缺失的数据，研究了东欧 22 个国家的 128 个部委和主管部门，并联系了 165 人。
不同国家的社会保险制度差异很大，有些国家的社会保险制度比其他国家更完善。此外，并非所有数据都可用。由于这些原因，并非总是可以进行详细比较。超过一半的国家的职业事故发生率正在下降。相比之下，一半的国家的致命事故率有所上升。超过一半的国家新登记的职业病数量正在减少。2006 年，捷克共和国、波兰和斯洛伐克的职业性皮肤病发病率特别高。在一半的国家（8 个中的 4 个），职业性皮肤病的数量正在减少。由于缺乏当前数据，无法对欧盟成员国身份与职业事故和职业病发病率之间的任何相关性进行可靠分析。
对东欧 22 个国家的社会保险制度和职业事故及职业病变化的比较清楚地表明，需要进一步努力制定登记和通知程序。只有这样，才能分析变化，描绘成功和问题，并可能启动必要的改进。还必须改进文件的标准化，以允许对各系统进行国际比较。
