Elsner Peter
Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Str. 35, 07743, Jena, Deutschland.
Hautarzt. 2021 Jun;72(6):509-515. doi: 10.1007/s00105-021-04776-7. Epub 2021 Feb 25.
Occupational disease (German: Berufskrankheit, BK) No. 5101 was previously defined as a "serious or recurrent skin disease that has forced a person to refrain from all activities that were or could be the cause of the development, aggravation or recurrence of the disease". In a far-reaching reform of the occupational disease law, which came into force on 01 January 2021, the German legislature decided to abolish the "obligation to refrain" as a prerequisite for the recognition of an occupational disease. To avoid this "obligation to refrain" was the motivation to introduce the "dermatologist's procedure" in 1972. The prevention instruments established in this procedure (dermatological treatment, workplace sanitation, skin protection measures, health education) were successful in the majority of cases. While the abolition of the "obligation to refrain" will, on the one hand, facilitate the recognition of serious or recurrent skin diseases as occupational diseases, the "dermatologist's procedure" will, however, continue to be important for occupational skin diseases, especially cases of hand eczema, which primarily do not meet the criteria of severity and/or recurrence and which can be controlled by appropriate treatment and prevention measures. In order to avoid delays in secondary prevention when notifying an occupational disease, a supplementary dermatological report to the disease notification should provide accident insurance carriers with the information necessary for timely prevention measures and dermatological treatment. An indication for the severity of the skin disease might be the success or failure of the "dermatologist's procedure".
职业病（德语：Berufskrankheit，BK）第5101号以前被定义为“一种严重或复发性皮肤病，致使一个人不得不停止所有可能是导致该疾病发生、加重或复发的活动”。在2021年1月1日生效的一项影响深远的职业病法改革中，德国立法机构决定废除将“停止工作的义务”作为认定职业病的一项前提条件。避免这种“停止工作的义务”是1972年引入“皮肤科医生程序”的动机。该程序中确立的预防手段（皮肤科治疗、工作场所卫生、皮肤保护措施、健康教育）在大多数情况下都取得了成功。虽然废除“停止工作的义务”一方面将便于将严重或复发性皮肤病认定为职业病，然而，“皮肤科医生程序”对于职业性皮肤病，尤其是手部湿疹病例仍将很重要，这些病例主要不符合严重程度和/或复发标准，并且可以通过适当的治疗和预防措施得到控制。为了在报告职业病时避免二级预防出现延误，随疾病报告附上的补充皮肤科报告应向事故保险承保人提供及时采取预防措施和进行皮肤科治疗所需的信息。皮肤病严重程度的一个指标可能是“皮肤科医生程序”的成败。
