英国工作相关疾病与职业伤害监测体系概况及其启示

Overview of work-related diseases and occupational injury surveillance system in the UK

英国工作相关疾病与职业伤害监测体系由《伤害、疾病和危险事故报告规程2013》(RIDDOR)、劳动力调查(LFS)、健康和职业报告网−全科医生(THOR-GP)报告计划、专科医生报告计划等监测项目共同组成。本文简述了英国工作相关疾病与职业伤害监测体系中各个监测项目的监测范围、内容和方法,分析了各个监测项目的优缺点。其中,RIDDOR是由雇主向相关执法部门上报,数据易于获取但漏报严重,是致命性职业伤害的唯一数据源;LFS是有代表性的全国住户抽样调查,涵盖了职业伤害和工作相关疾病两方面,是非致命性职业伤害和压力、焦虑、抑郁等工作相关疾病的首要数据源,但收集的是基于自我感知、未经临床证实的数据;全科医生报告的是经临床确诊的工作相关疾病,在归因中更加科学,是工作相关疾病的良好次要来源;专科医生报告的是经临床确诊的严重程度较高的病例,是哮喘、皮炎等疾病的首要数据源,但可能会低估发病率。该体系的各个监测项目各有特点,相互交叉,相互补充,可为我国构建职业伤害监测体系提供借鉴与参考。

The UK's work-related diseases and occupational injury surveillance system consists of Reporting of Injuries,Diseases and Dangerous Occurrences Regulations 2013(RIDDOR),Labour Force Survey(LFS),The Health and Occupation Research network in General Practice(THOR-GP),and Reporting to The Health and Occupation Research network by specialist physicians.This article briefly described the scope,content,and methods of each surveillance programme in the UK work-related diseases and occupational injury surveillance system,and summarized their advantages and disadvantages.Among them,employers are required to report to relevant law enforcement authorities by RIDDOR,data are highly accessible but with a concern of serious underreport,and it is the only data source of fatal occupational injuries;LFS,a representative national household sample survey,covering occupational injuries and work-related diseases,is the primary data source of non-fatal occupational injuries and work-related diseases such as stress,anxiety,and depression,but collects non-clinically proven data based on self-perception;general practitioners report clinically confirmed work-related diseases,which is more scientific in attribution and is a good secondary source of work-related diseases;specialist physicians report clinically confirmed cases of higher severity,which is the primary source of data on conditions such as asthma and dermatitis,but may underestimate morbidity.Each surveillance programme of the system has its own characteristics,intersects,and complements each other,which can provide reference for the construction of occupational injury surveillance system in China.