Sector: -cross sectoral-

Type of hazard: -various-

Catchwords: skin diseases (except cancer), quality assurance, evaluation

Status: under way since 09/2007

Financed by: Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)

Research institution(s): Universität Osnabrück

Description, key words:

dermatologist

Aims:

Occupational dermatoses (OD) have been at the top of all occupational diseases in Germany for years; presently, approximately 16,000 new OD-cases are officially reported to the public statutory employers' liability insurances per annum. For secondary prevention, the socalled dermatologist's procedure (Hautarztverfahren) was recently updated in order to provide more rapid and effective dermatological consultations. In addition, an administrative multi-step-intervention procedure for OD (Stufenverfahren Haut) was implemented by the DGUV which is aiming at offering quick preventive help at all levels of severity of OD after the insurance is informed about an OD-case. In this study, for the first time, a scientifically based quality assessment of these two complementary elements will be conducted. The study is aiming at further optimizing cost-effectiveness for society by further improving early prevention/professional case-management of OD and - at the same time - to save the individual the imminent threats of job-loss by OD.

Activities/methods:

From Sept. 1st, 2007 the optimised dermatologist's procedure and the new administrative multi-step-intervention procedure for OD will be scientifically assessed in a combined fashion:
- Quota-based nationwide cohort of 1,000 OD-cases reported to the DGUV by a dermatologist's report and subsequently receiving dermatological consultations in the framework of a dermatologist's procedure
- Follow up: one year
- Double review medical (and consecutive administrative) expert evaluations. Ca. 1/3 of the cohort will additionally be clinically examined (sub-cohort "secondary individual prevention" [SIP]).
As further controls will serve:
a) N = 200 OD-cases, who are still employed and who have not been reported to the DGUV by a dermatologist's report and subsequently have not received dermatological consultations in the framework of a dermatologist's procedure
b) N = 200 employees, who have already lost their job due to OD and are receiving job-re-training benefits by the DGUV without (ever) having been re-ported by a dermatologist while they were still employed.
An additional OD-patient survey in the various cohorts by standardised questionnaire will allow a comparative analysis of acceptance of early prevention procedures by the insured parties. For the first time, the study will make it possible to assess the complex interactions between the reporting dermatologists, the insured parties and the administration. This combined assessment will be conducted on the background of the accuracy of information given by the reporting dermatologist, the severity and course of the skin disease, and if the pt. could remain in his job. By the study, normative influences are likely to be generated in terms of maximal efforts of all involved parties to further improve secondary prevention of OD in Germany.

E-Mail: dguv.forschungsfoerderung@dguv.de

last update: 07.01.2009