Health surveillance without responsibity for surveillance failures is ineffective

James Mackie reports the results of surveillance for a large group of motor vehicle repairers exposed to isocyanate containing paints. The company contracted to do the health surveillance provided a questionnaire and spirometry, supervised by nurses, and a paper review of abnormal responses by a qualified occupational physician. If the OP thought that occupational asthma was possible, referral to the workers GP was made with a request for on-referral to a respiratory specialist. Of 92 referred to a GP only 32 were referred to a specialist and only 20 attended, 9 of whom were diagnosed as occupational asthma. This shows how a surveillance scheme which does not include responsibility for surveillance failures is unlikely to be effective.

References

	Mackie J, Effective health surveillance for occupational asthma in motor vehicle repair, Occup Med (London), 2008;58:551-555,

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