Department of Health Sciences of the University of Milano and International Centre for Rural Health of the San Paolo Hospital, 20142 Milano, Italy.
Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven 3000, Belgium.
Occup Med (Lond). 2017 Oct 1;67(7):574-578. doi: 10.1093/occmed/kqx113.
European Union (EU) Directive 89/391 addressed occupational health surveillance, which recommends to provide workers with 'access to health surveillance at regular intervals', aiming to prevent work-related and occupational diseases.
To investigate how EU countries adopted this Directive.
We invited one selected representative per member state to complete a questionnaire.
All 28 EU countries implemented the Directive in some form. Workers' health surveillance (WHS) is available to all workers in 15 countries, while in 12, only specific subgroups have access. In 21 countries, workers' participation is mandatory, and in 22, the employer covers the cost. In 13 countries, access to WHS is not available to all workers but depends on exposure to specific risk factors, size of the enterprise or belonging to vulnerable groups. In 26 countries, the employer appoints and revokes the physician in charge of WHS. Twelve countries have no recent figures, reports or cost-benefit analyses of their WHS programmes. In 15 countries where reports exist, they are often in the native language.
Coverage and quality of occupational health surveillance should be evaluated to facilitate learning from good practice and from scientific studies. We propose a serious debate in the EU with the aim of protecting workers more effectively, including the use of evidence-based WHS programmes.
欧盟指令 89/391 涉及职业健康监测，建议为工人提供“定期接受健康监测的机会”，旨在预防与工作相关和职业疾病。
调查欧盟国家如何采用该指令。
我们邀请每个成员国的一名代表完成一份问卷。
所有 28 个欧盟国家都以某种形式实施了该指令。15 个国家为所有工人提供工人健康监测（WHS），而在 12 个国家中，只有特定的亚组可以获得。在 21 个国家中，工人的参与是强制性的，在 22 个国家中，雇主承担费用。在 13 个国家中，并非所有工人都可以获得 WHS，但取决于接触特定的危险因素、企业规模或属于弱势群体。在 26 个国家中，雇主指定和撤销负责 WHS 的医生。12 个国家没有最新的 WHS 计划数据、报告或成本效益分析。在 15 个有报告的国家中，报告通常是用本国语言编写的。
应评估职业健康监测的覆盖范围和质量，以便从良好实践和科学研究中学习。我们建议在欧盟进行认真的辩论，目的是更有效地保护工人，包括使用基于证据的 WHS 计划。
