Gyo Christoph, Boll Michael, Brüggmann Dörthe, Klingelhöfer Doris, Quarcoo David, Groneberg David A
The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
J Occup Med Toxicol. 2016 Oct 12;11:47. doi: 10.1186/s12995-016-0136-3. eCollection 2016.
State-certified occupational physicians who work as civil servants in the Federal Republic of Germany are key players in the German Public Health system. They control i.e. the legal compliance in occupational health and participate in the occupational disease procedures. Despite the role model function of the German Public health system for many developing countries, this area of Public health is debated to have been hampered in the past years by a disregard concerning structural developments.
Different databases were screened for occupational health benchmarks. Obtained data were compared to socioeconomic data and indices were calculated.
The overall numbers of State-certified occupational physicians decreased in Germany between 1992 and 2012 from 136 to 86 (63 %). On the single state level, the ratios of State-certified occupational physicians per 1 Mio. working population ranged from 8 for the state of Saarland to 0.8 for the state of North Rhine Westphalia. A general difference was found for old versus new German states. Also, large differences were present for the ratios of State-certified occupational physicians per 10 employees towards public debt per capita (€) and the ratios of State-certified occupational physicians per Gross Domestic Product (GDP) in the 16 German states in 2012.
In striking contrast to the WHO document on the Occupational safety and health (OSH) system that states in its executive summary that the human and institutional capacities of the German occupational health system are very strong in both quantity and quality, we here show extreme imbalances present at the single state levels that developed over the past 20 years. With a regard to the increasing complexity of the economic system a reversal of this trend should be demanded.
在德意志联邦共和国担任公务员的国家认证职业医师是德国公共卫生系统的关键角色。他们负责监督职业健康方面的法律合规情况，并参与职业病程序。尽管德国公共卫生系统对许多发展中国家具有示范作用，但过去几年该公共卫生领域被认为因忽视结构发展而受到阻碍。
对不同数据库进行职业健康基准筛查。将获得的数据与社会经济数据进行比较并计算指数。
1992年至2012年间，德国国家认证职业医师的总数从136人降至86人（减少了63%）。在单个州层面，每100万工作人口中获得国家认证的职业医师比例从萨尔兰州的8人到北莱茵 - 威斯特法伦州的0.8人不等。德国老州和新州之间存在总体差异。此外，2012年德国16个州每10名员工中获得国家认证的职业医师比例与人均公共债务（欧元）以及与国内生产总值（GDP）的比例也存在很大差异。
与世界卫生组织关于职业安全与健康（OSH）系统的文件形成鲜明对比，该文件在执行摘要中指出德国职业健康系统的人力和机构能力在数量和质量上都非常强大，而我们在此表明过去20年中单个州层面出现了极端不平衡。鉴于经济系统日益复杂，应要求扭转这一趋势。
