University of Medicine and Pharmacy of Tirgu-Mures, Tirgu-Mures, Romania.
Department of Dermatology and Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany.
J Eur Acad Dermatol Venereol. 2017 Jun;31 Suppl 4:5-11. doi: 10.1111/jdv.14315.
While legislation in most of the Eastern European countries is nowadays widely harmonized with the legal safety and health provisions of Western countries, there is still a sustained resistance to the notification of occupational skin diseases (OSD).
The aim of the study was to identify the main barriers in notification and recognition of OSD in 22 Eastern European countries.
An online survey was administered to key persons in the field of occupational safety and health in 22 Eastern European countries. Multiple variables of the notification system were studied, including clinical, organizational and educational issues.
The main causes of underreporting OSD are ineffective enforcement of occupational safety and health legislation, contractual relationship employer-employee, long duration of the notifying process, restrictions of the notification systems in terms of who is entitled to notify an OSD, ineffective regulations in regards to the pre-employment and periodical medical examination, ineffective compensation schemes, restraints and hesitations, mainly from the doctors, inappropriate mentalities - fear of losing the jobs, fining of the employers by the authorities, stigmatization of the workers with OSD, additional costs for employers, stakeholders' lack of interest in notifying, lack of guidelines and protocols and lack of preventive programmes.
The most valuable method for a proper recognition of OSD is to increase the awareness of physicians involved in the management of OSD (occupational physicians, GPs, dermatologists), as well as employers and workers. There is an urgent need to improve national legislation, to develop and promote adequate preventive programmes, emphasizing ethical, legal, economical and psychological aspects in order to achieve an increased recognition and a real reporting of OSD, and to enforce an international action plan for Eastern Europe in order to improve the notification of OSD.
如今，东欧大部分国家的立法与西方国家的法律安全和健康规定广泛接轨，但对职业性皮肤病（OSD）的通报仍存在持续抵制。
本研究旨在确定 22 个东欧国家在 OSD 通报和识别方面的主要障碍。
对 22 个东欧国家职业安全与健康领域的关键人员进行了在线调查。研究了通报系统的多个变量，包括临床、组织和教育问题。
OSD 漏报的主要原因是职业安全和健康立法执行不力、雇主-雇员的合同关系、通报过程耗时过长、通报系统在谁有权通报 OSD 方面的限制、关于就业前和定期体检的规定无效、补偿计划无效、限制和犹豫，主要来自医生、不适当的心态——害怕失去工作、当局对雇主罚款、对患有 OSD 的工人进行污名化、雇主的额外成本、利益相关者对通报缺乏兴趣、缺乏指导方针和协议以及缺乏预防计划。
适当识别 OSD 的最有价值方法是提高参与 OSD 管理的医生（职业医生、全科医生、皮肤科医生）、雇主和工人的意识。迫切需要改进国家立法，制定和推广适当的预防计划，强调伦理、法律、经济和心理方面，以提高对 OSD 的认识和真实报告，并执行针对东欧的国际行动计划，以改善 OSD 的通报。
