Occupational diseases in Figures 2009: many complaints of knee and hip 28.01.2010

"Statistics on Occupational Diseases 2009” is a report compiled by the Netherlands Center for Occupational Diseases (NCvB) and commissioned by the Dutch Ministry of Social Affairs and Employment. The report aims to provide an overview of the incidence of occupational diseases and their distribution within the sectors and occupations in the Netherlands in 2008. The report provides information on occupational diseases that may be of use in both policy and practice. Where possible, it also includes socio-demographic indicators and trends for the distribution of occupational diseases. In addition to statistical data, the report also includes a description of the scientific and social developments relating to the various categories.

Below a summary of the results:

Noise
With 2,290 notifications (33%), hearing disorders were the most commonly reported occupational diseases in 2008. Working in noisy conditions can increase the likelihood of error and of accidents. In order to meet the modern requirements for auditory communication and the identification of warning signals within the employment situation, it is necessary not only to reduce noise exposure at its source, but also to develop a new generation of customised tools and protective equipment.

Posture and musculoskeletal system
A total of 42% of all notifications concern occupational diseases relating to posture and the musculoskeletal system. There has been a significant increase (30%) in this figure in the last two years. There has also been a change in the distribution of diseases over the body; there have been more reports of occupational diseases relating to disorders in the lumbar region and the lower limbs. In particular, the number of occupational disease notifications relating to arthritis in the knee and hip has seen a significant increase in the last two years. The number of notifications of RSI fell from 3000 in the year 2000 to 1061 in 2008.

Psychological occupational diseases
Most of the 1170 notifications of psychological occupational diseases related to overexertion and burnout. Occupational physicians estimate that employment-related psychological disorders generally go hand in hand with long-term absenteeism. Newly-identified risks for employment-related psychological disorders include increased intensity of work and an imbalance between employees’ work and private life.

Skin diseases
Reports of occupational skin diseases account for 2.7% of all notifications. The majority of these concern contact dermatitis. As in previous years, dermatologists’ surveillance project reports primarily concern contact dermatitis, skin cancer and urticaria. In more than half of contact dermatitis notifications, irritant factors and especially working in wet conditions play the most significant role rather than specific allergies. Of particular note are the reports from drug treatment centres relating to skin and mucous membranes disorders among nursing and security staff exposed to heroin which has not been effectively removed.

Pulmonary and respiratory disorders
The number of notifications of occupational pulmonary and respiratory disorders (1.8% of all notifications) has remained relatively constant in recent years. There have been no obvious shifts in the distribution across different sectors and occupations or in the causes. The increase in the number of notifications of flour dust allergy in the last two years within the surveillance project of lung and allergy specialists can be attributed to the active detection of this disorder in the bakery sector. Classic occupational diseases such as silicosis are now occurring in less familiar employment situations, for example in cable production.

Solvents and pesticides
The number of cases of organic brain syndrome (OPS in Dutch) caused by exposure to solvents has fallen significantly from around 50 in 2000 to five in 2008. This decrease can be attributed to the reduced exposure to solvents in various different sectors. The number of new cases appears to have been permanently reduced in the Netherlands. Exposure to pesticides increases the likelihood of neurodegenerative diseases such as Parkinson's and Alzheimer's.

Infectious diseases
There have been relatively few reports of occupational infectious diseases (117 notifications). This underreporting may be related to the large number of different causes of infectious diseases or insufficient knowledge of infectious diseases and employment.

Cancer
In total, 16 cases of occupation-related cancer were reported. Most of these concerned skin cancer. The low number of reports of cancer as an occupational disease compared to the actual number of cases can probably be explained by the extended period between exposure to carcinogenic materials and the development of symptoms. Work-related cancer is the most significant cause of employment-related death. Approximately 8% of all types of cancer among men and 1.5% of cancer among women are caused by employment-related factors. These are largely the consequence of historic exposure such as exposure to asbestos.

Reproductive disorders
There were no occupational disease notifications relating to reproductive disorders. This is a known phenomenon and is caused by the difficulty of identifying a causal relationship between the disorder and exposure at work in individual cases of reproductive disorders.

New risks and vulnerable groups
The ageing population, improved treatment of chronic diseases and reintegration all mean that increasing numbers of people are continuing to work despite having compromised immunity and these people are especially vulnerable to biological agents. This group of vulnerable employees should be the subject of more targeted focus.
There are indications that shift work and exposure to certain agents, such as arsenic, can increase the likelihood of diabetes and therefore also cardiovascular disorders. Night work can increase the risk of breast cancer. The renowned International Agency for Research on Cancer (IARC in Lyon) has included chronic disruption of biorhythms on its list of carcinogenic substances and processes. Further research is desirable, also into the effect of improved shift-rostering.

In the last two years, the United States has seen the unexpected emergence of two new occupational health risks with serious neurological effects (confusion and motor and sensory disorders): one is the result of a new slaughtering method used in pig slaughterhouses and the other is caused by the widescale application of 1-bromopropane.

Known causes of allergic contact dermatitis such as acrylates and epoxy resins can also cause occupational asthma. The increasing use of lupin flour can result in a new form of flour dust allergy. Specific Sick Building symptoms such as work-related rhinitis may be the consequence of mould allergy arising from damp problems in buildings. Pregnant women who do physically challenging work or who work long hours are twice to three times as likely to develop pre-eclampsia (a serious form of high blood pressure in pregnant women). This underlines the need for pregnant women’s work to be adjusted at an early stage.

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