Harrington J M
Institute of Occupational Health, University of Birmingham, Edgbaston, UK.
Occup Environ Med. 1994 May;51(5):289-94. doi: 10.1136/oem.51.5.289.
An attempt to achieve an agreed set of priorities for research in occupational medicine was undertaken by the Delphi technique. Fifty three senior practitioners of occupational medicine in academe (25) and industry or government (28) were canvassed about their views and choices for priority activity. Forty six (86%) responded to the initial enquiry and 48 (91%) provided rank order choices from a second, more detailed questionnaire. The first priority for more research on the natural history of work related ill health identified musculoskeletal disorders of the back and upper limbs followed by asthma, accidents, skin disorders, vibration induced disease, suicide and depression, and finally hearing loss. The second priority area was audit and particularly the need for its use in occupational health screening procedures. Environmental impact of industrial activity was third with the community health effects being more important than individual health effects. Stress related disease was fourth with emphasis on risk factors. The fifth area was neuropsychological effects of work exposures particularly the need for more research on diagnostic tests. Other assorted areas of concern were the cost effectiveness of occupational health, risk assessment, reproductive hazards, the effects of pharmacological agents, and the development of biomarkers as early evidence of an exposure effect. The remarkable degree of unanimity on the issues and choices and the general agreement between physicians from academe and industry on what constitute the priorities warrants further discussion and positive action.
采用德尔菲技术尝试为职业医学研究确定一套商定的优先事项。我们向53位职业医学资深从业者进行了调查，他们来自学术界（25人）、工业界或政府部门（28人），询问他们对优先活动的看法和选择。46人（86%）回复了初始询问，48人（91%）对第二份更详细的问卷提供了排序选择。关于对与工作相关的健康不良自然史进行更多研究的首要优先事项，确定为背部和上肢的肌肉骨骼疾病，其次是哮喘、事故、皮肤疾病、振动引起的疾病、自杀和抑郁症，最后是听力损失。第二个优先领域是审核，特别是在职业健康筛查程序中使用审核的必要性。工业活动的环境影响排在第三位，社区健康影响比个人健康影响更重要。与压力相关的疾病排在第四位，重点是风险因素。第五个领域是工作接触的神经心理影响，特别是需要对诊断测试进行更多研究。其他各种关注领域包括职业健康的成本效益、风险评估、生殖危害、药物制剂的影响以及作为接触效应早期证据的生物标志物的开发。在这些问题和选择上达成的高度一致，以及学术界和工业界医生在确定优先事项方面的总体共识，值得进一步讨论和采取积极行动。
