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1.  Epidemiological and performance indicators for occupational health services: a feasibility study in Belgium 
Background
In many European countries, Occupational Health and Safety (OHS) providers report their activities and results annually. Ideally, this report should offer an overview of their activities and of the outcome regarding occupational health and safety. To establish a set of epidemiological and performance indicators for electronic reporting of data that can be used for OHS surveillance and prevention purposes. Consequently, the selected data can serve as indicators for exposure to and prevention of occupational risks (epidemiology), and contribute to the evaluation of the functioning (performance) of OHS providers.
Methods
An extensive literature search in combination with an investigation of existing reporting models was performed. The resulting list of potential indicators was assessed by different stakeholders and divided into indicators for epidemiology and for performance. Then in a feasibility study, the relevance and availability of the indicators were assessed in 17 external, 49 internal (in company) and 10 mixed OHS providers.
Results
From the literature survey, we obtained 1100 indicators. After validation, 257 were taken into account in the feasibility study. An indicator was considered relevant when more than 2/3 of the respondents answered in favour of the indicator. The same criterion was applied for availability. Respectively, 82% and 62% of the performance and epidemiological indicators were considered to be relevant for external OHS providers. All relevant performance indicators were available. Of the epidemiological data, only 53% were available. Remarkably, internal OHS providers assessed fewer indicators as relevant (29% and 27% of performance and epidemiology indicators respectively), but these were mostly all available (90%).
Conclusions
This study shows that it is possible to provide a snapshot of the state of OHS by means of the registration of data. These findings could be used to build a data warehouse to study national health and safety profiles and to develop a uniform report for all European countries.
Electronic supplementary material
The online version of this article (doi:10.1186/1472-6963-14-410) contains supplementary material, which is available to authorized users.
doi:10.1186/1472-6963-14-410
PMCID: PMC4180330  PMID: 25236590
Performance indicators; Epidemiology indicators; Occupational health services
2.  Physical characteristics of the back are not predictive of low back pain in healthy workers: A prospective study 
Background
In the working population, back disorders are an important reason for sick leave and permanent work inability. In the context of fitting the job to the worker, one of the primary tasks of the occupational health physician is to evaluate the balance between work-related and individual variables. Since this evaluation of work capacity often consists of a physical examination of the back, the objective of this study was to investigate whether a physical examination of the low back, which is routinely performed in occupational medicine, predicts the development of low back pain (LBP).
Methods
This study is part of the Belgian Low Back Cohort (BelCoBack) Study, a prospective study to identify risk factors for the development of low back disorders in occupational settings. The study population for this paper were 692 young healthcare or distribution workers (mean age of 26 years) with no or limited back antecedents in the year before inclusion. At baseline, these workers underwent a standardised physical examination of the low back. One year later, they completed a questionnaire on the occurrence of LBP and some of its characteristics. To study the respective role of predictors at baseline on the occurrence of LBP, we opted for Cox regression with a constant risk period. Analyses were performed separately for workers without any back antecedents in the year before inclusion ('asymptomatic' workers) and for workers with limited back antecedents in the year before inclusion ('mildly symptomatic' workers).
Results
In the group of 'asymptomatic' workers, obese workers showed a more than twofold-increased risk on the development of LBP as compared to non-obese colleagues (RR 2.57, 95%CI: 1.09 – 6.09). In the group of 'mildly symptomatic' workers, the self-reports of pain before the examination turned out to be most predictive (RR 3.89, 95%CI: 1.20 – 12.64).
Conclusion
This study showed that, in a population of young workers wh no or limited antecedents of LBP at baseline, physical examinations, as routinely assessed in occupational medicine, are not useful to predict workers at risk for the development of back disorders one year later.
doi:10.1186/1471-2474-10-2
PMCID: PMC2630962  PMID: 19123931

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