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Background: Multiple sclerosis (MS) can impact working life, sickness absence (SA) and disability pension (DP). Different types of occupations involve different demands, which may be associated with trajectories of SA/DP among people with MS (PwMS). Objectives: To explore, among PwMS and references, if SA/DP differ according to type of occupation. Furthermore, to examine how trajectories of SA/DP days are associated with type of occupation among PwMS. Methods: A longitudinal nationwide Swedish register-based cohort study was conducted, including 6100 individuals with prevalent MS and 38,641 matched references from the population. Trajectories of SA/DP were identified with group-based trajectory modelling. Multinomial logistic regressions were estimated for associations between identified trajectories and occupations. Results: Increase of SA/DP over time was observed in all occupational groups, in both PwMS and references, with higher levels of SA/DP among PwMS. The lowest levels of SA/DP were observed among managers. Three trajectory groups of SA/DP were identified: Persistently Low (55.2%), Moderate Increasing (31.9%) and High Increasing (12.8%). Managers and those working in Science & Technology, and Economics, Social & Cultural were more likely to belong to the Persistently Low group. Conclusion: Results suggest that type of occupation plays a role in the level and course of SA/DP.

Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.

Purpose This study describes the development of an evidence-based intervention to create a supportive work environment for employees with chronic conditions. Occupational physicians (OPs) play an important role in guiding organizations in this process of organizational change. Supportive work environments can aid in preventing work-related problems and facilitate sustainable employment. Current workplace interventions for employees with chronic conditions are mainly focused on return to work or a reduction in sick leave at the individual worker’s level. This study contributes to the literature an organizational-level intervention which utilizes a preventive approach. Methods Intervention mapping (IM) is a six-step, structured protocol that was used to develop this intervention. In step 1, a needs assessment was conducted to define the problem and explore the perspectives of all stakeholders involved. The program outcomes and the performance objectives of employees with chronic conditions and occupational physicians were specified in step 2. In step 3, appropriate methods and practical applications were chosen. Step 4 describes the actual development of the intervention, consisting of (1) a training for occupational physicians to teach them how to guide organizations in creating a supportive work environment; (2) a practical assignment; and (3) a follow-up meeting. The intervention will be implemented in a pilot study in which occupational physicians will put their acquired knowledge and skills into practice within one of their organizations, which is delineated in step 5. Conclusions IM proved to be a valuable and practical tool for the development of this intervention, aiming to facilitate sustainable employment for employees with chronic conditions. Electronic supplementary material The online version of this article (10.1007/s10926-020-09885-z) contains supplementary material, which is available to authorized users.

Background To limit students’ medical absenteeism and premature school dropout in the Netherlands, the Medical Advice for Sick-reported Students (MASS) intervention was developed to enhance collaboration between students, parents, school, and health care professionals. MASS reduces medical absenteeism. However, it does not yet optimally support professionals in monitoring students nor automatically stimulating students’ autonomy regarding their situation. Objective This study aimed to identify professionals’ and students’ perceived need for an online supportive application to monitor and reduce absenteeism and stimulate student autonomy and school reintegration. Methods Concept mapping sessions were held with professionals (n=23) and secondary school students (n=27) in group meetings or online to identify their perspectives and needs. Multidimensional scaling and hierarchical clustering were done with Ariadne 3.0 software. The resulting concept maps were reclustered and interpreted by 4 researchers. Results Three heterogeneous groups of professionals generated 17 clusters (135 unique statements), with a mean importance rating ranging from 2.9 to 4.6 on a Likert scale with scores ranging from 1 to 5. Three heterogeneous groups of secondary school students generated 18 clusters (95 unique statements), with a mean importance rating ranging from 3.2 to 4.6. Professionals considered as most important the following: easily accessible contact with students; supporting, motivating, and rewarding students; monitoring absent students; providing information to students and their parents; exchanging information between professionals. Students considered as most important the following: better teacher-student communication and respect; communication between school professionals on the one hand and parents, other professionals, and students on the other hand; guidance in missed learning materials and tests. Students perceived an online format for support as the obvious option. Conclusions Both professionals and students were positive about an online application to support students in dealing with medical absenteeism, especially considering the need for better and easily accessible contact between students and professionals. An eHealth or mobile health (mHealth) application addressing these aspects could stimulate student autonomy and have positive effects on medical absenteeism.

Contains fulltext : 207937.pdf (Publisher’s version ) (Open Access) Working while having a chronic condition can be challenging. Self-control at work could play an important role for workers with a chronic condition in sustainable work participation. The aim of this qualitative synthesis is to profile elements of self-control at work and to gain insight in its exertion, from the perspective of workers with a chronic condition. Four databases were systematically searched for relevant articles from January 2007 to October 2017 (PubMed, PsycINFO, Embase, and CINAHL). Search terms were related to work, seven prevalent chronic conditions, subjective needs to continue working, and qualitative research. The included articles were thematically analyzed using ATLAS.ti. The search yielded 6,445 articles of which 17 studies were included. Four elements of self-control at work for workers with a chronic condition were identified: disclosure, finding a healthy balance, requesting work accommodations and support, and management of symptoms and limitations in the workplace. These elements of self-control at work for workers with a chronic condition are helpful in developing a strategy for occupational health professionals to support these workers in strengthening their self-control and to facilitate sustainable employment. 16 p.

Additional file 1: Supplementary file 1. COREQ checklist - The completed COREQ (32-item) checklist

Additional file 2: Supplementary file 2. Interview guide - The interview guide used for the interviews with organizational representatives

OBJECTIVES: Workplace-based selective prevention of mental health problems currently relies on subjective evaluation of stress complaints. Hair cortisol captures chronic stress responses and could be a promising biomarker for the early identification of mental health problems. The objective was to provide an overview of the state-of-the-art knowledge on the practical value of hair cortisol in the occupational setting. METHODS: We performed a scoping review of cross-sectional and longitudinal studies in PubMed, Embase, and PsycINFO up to November 2019 assessing the relations of hair cortisol with work-related stressors, perceived stress, and mental health outcomes in healthy workers. RESULTS: We found five longitudinal studies, of which two observed an increase in work-related stressors to be associated with higher hair cortisol, one found a relation with lower hair cortisol and one did not find a relationship. Findings of cross-sectional studies were also mixed. The one available longitudinal study regarding mental health showed that hair cortisol was not related to depressive symptoms. CONCLUSIONS: Hair cortisol measurement within occupational health research is still in its early stage and more longitudinal studies are urgently needed to clarify its relationship with work-related stressors and perceived stress before hair cortisol can be used to identify workers at risk for mental health problems.

Contains fulltext : 249250.pdf (Publisher’s version ) (Open Access) 1 p.

Examination of prognostic factors for staying at work for long-term sick-listed workers with subjective health complaints (SHC) who partially work in a paid job, and to evaluate whether these factors are comparable with those of workers with other disorders. We used data of 86 partially sick-listed workers with SHC (57 females, 29 males, mean age 47.1 years) and 433 with other disorders (227 females, 206 males, mean age 50.9 years), from an existing prospective cohort study consisting of 2593 workers aged 18&ndash, 65 years and registered as sick-listed with different health complaints or disorders for at least 84 weeks in the database of the Dutch Social Security Institute. We performed univariable logistic regression analyses (p &le, 0.157) for all independent variables with the dependent variable staying at work for the workers with SHC. We then performed multivariable logistic regression analyses with forward selection (p &le, 0.157) and combined the remaining factors in a final, multivariable model (p &le, 0.05), which we also used for logistic regression analysis in the workers with other disorders. The following factors were significant prognostic factors for staying at work for workers with SHC: full work disability benefits (odds ratio (OR) 0.07, 95% confidence interval (95% CI) 0.01&ndash, 0.64), good mental health (OR 1.08, 95% CI 1.02&ndash, 1.14), positive expectations for staying at work (OR 6.49, 95% CI 2.00&ndash, 21.09), previous absenteeism for the same health complaint (OR 0.31, 95% CI 0.10&ndash, 0.96) and good coping strategies (OR 1.13, 95% CI 1.04&ndash, 1.23). For workers with other disorders, full work disability benefits, good mental health and positive expectations for staying at work were also prognostic factors for staying at work. Individual and policy factors seem to be important for staying at work of sick-listed workers with SHC and those with other disorders alike, but several biopsychosocial factors are particularly important for workers with SHC.

Additional file 2. Logic model of chance. A summary of the behavioral and environmental determinants, performance objectives and outcomes.

Background Workers with a low socioeconomic position (SEP) have a higher risk for health problems and premature dropout from the workforce. Unfavorable working conditions and unhealthy behaviors are more prevalent among this group of workers. The Participatory Approach (PA), is an evidence-based method to identify and solve problems at the workplace related to health issues of the worker. Health problems among workers with a low SEP are usually caused by an interplay of problems in and outside the workplace. To solve health problems on multiple life domains for workers with a low SEP we aim to adapt this approach to a broader perspective. Methods An Intervention Mapping (IM) protocol was used to adapt the PA. First, a needs assessment was conducted combining literature with data from interviews and focus groups with workers with a low SEP, employers and occupational health professionals (OHPs). Based on the needs assessment a program goal and performance and change objectives were defined, which resulted in methods and practical strategies to solve problems on multiple life domains. Based on the results of these steps, the PA was adapted and an implementation and evaluation plan were developed. Results The needs assessment confirmed that an interplay of problems on multiple life domains affect work functioning and health of workers with a low SEP. Moreover, they perceived difficulties with solving problems or used passive or avoidant coping styles towards these problems. The program goal is to identify and solve problems on multiple life domains that affect healthy functioning at work. To achieve this workers need support from OHPs to solve problems. The PA protocol and materials were adapted using theoretical concepts of the Self-Determination Theory (SDT), which resulted in the Grip on Health intervention. For OHPs a training was developed on how to implement this intervention in practice. The intervention will be evaluated in a pilot implementation study among workers with a low SEP and other relevant stakeholders. Conclusions IM was a valuable tool for the adaptation of the PA to better support workers with a low SEP to improve their work functioning and health from a broader perspective.

Additional file 4. Matrices of change for the environmental outcome. Change objectives for the environmental outcome to identify what OHPs need to learn or change to achieve the performance objectives.

Additional file 3. Matrices of change for the behavioral outcome. Change objectives for the behavioral outcome to identify what workers with a low SEP may need to learn or change to achieve the performance objectives.

Additional file 1. Interview guides for the interviews and focus groups with workers with a low SEP, OHPs and employers.

Background The increase in prevalence of colorectal cancer among young patients coupled with an older retirement age in developed countries means that more patients are being diagnosed with colorectal cancer while still at work. The aim of this study was to develop prediction models for return to work by 1 and 2 years after the start of sick leave. Methods This was a retrospective registry‐based cohort study of data from a nationwide occupational health service in the Netherlands. Only employed patients with colonic or rectal cancer treated with curative intent were included. Two predictor variable models were developed using multivariable logistic regression with backward selection. Calibration, discrimination and explained variance were used to assess model performance, and internal validation by bootstrapping was performed. Results Median time to return to work for 317 included patients was 423 (95 per cent c.i. 379 to 467) days. Two‐thirds of patients had returned to work by 2 years after the start of the sick leave. Presence of metastases, adjuvant treatment, stoma, emotional distress and postoperative complications were predictors of not returning to work in the 1‐year model. In the 2‐year model, presence of metastases, emotional distress, postoperative complications, company size and the trajectory of the return‐to‐work process were predictors. Conclusion Almost 70 per cent of patients with colorectal cancer in this population returned to work within 2 years after the start of sick leave. The models can be used to guide patients early in colorectal cancer treatment about the likelihood of returning to work, and to identify and modify barriers that could facilitate this., Almost 70 per cent of patients with colorectal cancer in this population returned to work within 2 years after the start of the sick leave period. The models in this study can be used to guide patients with colorectal cancer early in their treatment about their likelihood of returning to work, and to identify and modify barriers that could facilitate this. Most return at two years

Contains fulltext : 196761.pdf (Publisher’s version ) (Open Access) BACKGROUND: To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. METHODS: The implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain. Adherence was measured using performance indicators based on 3 months data extracted from the contacts with patients with low back pain recorded in the electronic medical records of participating general practitioners. Performance indicators were compared between two groups: a usual care group and an implementation group. Performance indicators were referrals to consultations with medical specialists, to diagnostic imaging, and to psychosocial and/or occupational physician consultations, and inquiries about psychosocial and occupational risk factors. RESULTS: The electronic medical records of 5130 patient contacts for LBP were analysed; 2453 patient contacts in the usual care group and 2677 patient contacts in the implementation group. Overall, rates of referral and of recorded inquiries regarding psychosocial and occupational risk factors remained low in both groups over time. The only statistically significant difference found was a reduction in the number of referrals to neurologists in the implementation group (from 100 (7%) to 50 (4%)) compared to the usual care group (from 48 (4%) to 50 (4%), (p < 0.01)). There were no other between-group differences in referrals. CONCLUSION: In the short term, the strategy did not result in improved guideline adherence among general practitioners, and it is not recommended for widespread use. However, baseline referral rates in participating practices were already low, possibly leaving only little room for improvement. Inquiries for psychosocial and occupational risk factors remained low and this leaves room for improvement. TRIAL REGISTRATION: This trial is registered in the Netherlands Trial Register (NTR): NTR4329 . Registration date: December 20th, 2013.

Introduction Specific low back problems are a common and costly problem in Western societies. The vast majority (88%) of these costs are caused by indirect costs, including job absenteeism, productivity losses, and disability. To reduce these costs, a multimedia campaign was developed for patients with low back pain. This campaign aimed to improve patient cognitions and knowledge regarding back pain, and stimulated active coping including continuing work. Methods We recruited patients via general practitioners and physiotherapists, and used a RCT design for evaluation. We compared the multimedia campaign to usual care. The campaign consisted of an interactive website, video films, social media and monthly newsletters. Social media included Facebook, Twitter and a patient forum. During the follow-up period of one year cognitions, knowledge, quality of life, absenteeism, and direct and indirect costs were measured and analysed for all patients. Results 779 patients with low back pain participated, of which 448 patients in the control group and 331 patients in the intervention group. The average age was 56 years, and most patients were women, with a high level of education and a Dutch nationality. In the control group, 232 participants had a paid job, of which 121 reported a physically demanding job. In the intervention group, 183 participants had a paid job, of which 88 reported a physically demanding job. The campaign had no effect on cognitions. The campaign was cost-effective for quality of life, but not for back pain cognitions. The costs for loss of productivity at work were higher in the control group than intervention group, resulting in a potential saving of € 748 per person. Discussion This multimedia campaign was not effective in improving cognitions in patients with low back pain, but could lead to a reduction in absenteeism costs. From a societal perspective, the campaign was cost-saving.

Introduction Physical, chemical and biological risk factors exist in workplaces of cleaning professionals. These risk factors at work may cause respiratory, skin, and musculoskeletal health problems for these workers. The prevalence of these health problems caused by occupational risk factors such as exposure to chemicals in cleaning products and physical strain in the workplace of cleaning professionals are not yet fully known in Turkey. For this reason, the objective was to assess the extent of workplace exposure to occupational risk factors for cleaning professionals of izmir, Antalya and Bursa Public Health Directorates (including subcontractors). Methods We plan a cross sectional study using a questionnaire on socio-demographic characteristics, risk factors at work, work history, health history, health status, exposures,European Community Respiratory Health Survey II(ECHRS II) questionnaire, Nordic Occupational Skin Questionnaire and the Nordic Musculoskeletal Questionnaire using a face-to-face interview method. The interviews will be performed by trained occupational health and safety specialists from the Public Health Directorates of izmir, Antalya and Bursa Turkey. The study proposal has been approved by 9thSeptember University Ethical Committee. Workers will be asked for informed consent before the survey. Result We will include 370 cleaning professionals in the study. The prevalence of respiratory, skin and musculoskeletal symptoms will be determined, stratified for different cleaning professionals and their socio-demographic variables. We expect all results in October 2017. Discussion The main outcome is the estimated prevalence of work-related disorders in cleaning professionals and associated occupational risk factors in Turkey. We will also analyse the effect of these disorders on the related prevalence of disability in work and daily life. Based on the results, interventions for prevention of will be recommended.

Introduction Musculoskeletal diseases (MSD) affect almost 30% of the global construction sectorworkforce. Recent studies have shown high risks in bricklayers, plasterers and carpenters. The main causes of MSD in construction workers are heavy lifting, repetitive movements and poor ergonomic working postures. However, there are no studies in Turkey assessing work-related MSD prevalence in the construction sectorand related disability in work and daily life. The aim of this study is to examine the prevalence of work related musculoskeletal symptoms and disability in manual handling construction workers active in the construction of new buildings for a city hospital in Ankara. Methods We plan a cross-sectional study using a questionnaire on sociodemographic characteristics, risk factors at work and employment conditions, work history, health status, the Nordic Musculoskeletal Questionnaire (NMQ), and disability, as a consequence of work-related MSD, using a supervised face-to-face interview method. The interviews will be performed by trained occupational health and safety specialists from the Public Health Institution of Turkey (PHIT). The study proposal has been approved by the PHITand the construction company. Workers will be asked for informed consent. Results We will include about 1.200 Turkish workers in the construction branch in the study. The prevalence of work-related MSD and disability will be determined, stratified for occupational groups and socio-demographic variables. Results are expected in October 2017. Discussion The main outcome is the estimated prevalence of work-related MSDs in construction workers and associated occupational risk factors in the construction branch of Turkey. We will also analyse the effect of these disorders on the prevalence of disability in work and daily life. Based on the results, interventions for prevention will be recommended.

Introduction The number of people in the working population diagnosed with one or more chronic diseases will increase. Self-management at work may facilitate workers with a chronic disease to continue working. Occupational and insurance physicians can play a key role in supporting this self-management at work, as this fits within their preventive task. The aim of this project is to explore how occupational and insurance physicians can optimally support chronically ill workers in improving their self-management at work. We will develop an intervention that will fit within the needs of all stakeholders involved, using Intervention Mapping (IM) as a tool. Methods The intervention will be developed with the use of the 6 step IM protocol: Needs assessment; Definition of change objectives; Selection of theory based methods and practical strategies; Program development; Adoption and implementation plan; Evaluation plan. Step 1, the needs assessment will consist of a systematic review of the literature and a qualitative explorative study using focus groups. In the focus groups with chronically ill workers, occupational and insurance physicians we will explore their perceptions on self-management at work, their needs for support in improving self-management at work and the views of occupational and insurance physicians on providing this support. Result The results of the needs assessment are expected early 2018 and will be available for presentation at the conference. Discussion The iterative steps of the IM protocol help to develop an intervention for occupational and insurance physicians that enables them to support workers with a chronic disease in improving self-management at work, to maintain productivity and to prevent sick leave and job loss.

Comparing assessments of incapacity to work in patients with subjective health complaints (SHC) by physicians from 5 different European countries.Cross-sectional study.General practitioners from Norway (n=56), Sweden (n=29), Denmark (n=41), France (n=46) and occupational and insurance physicians from the Netherlands (n=93) watched and assessed incapacity to work in nine video vignettes of patients with SHC. We subsequently analysed differences between assessments (whether or not there was incapacity to work) by country, with Norway as a reference, as well as differences between general practitioners from the four countries and occupational and insurance physicians using a generalised linear mixed model.Assessments of incapacity to work by physicians from the 5 countries were generally very similar. However, compared to Norwegian general practitioners, Swedish general practitioners (odds ratio (OR) of 0.43 with 95% confidence interval (CI) of 0.23-0.79) and Dutch occupational and insurance physicians (OR of 0.55 with 95% CI of 0.36-0.86) concluded less often that the patients in the videos were unable to work. There were no differences between general practitioners from the other 2 European countries and those from Norway. The Dutch occupational and insurance physicians also concluded less often that there was an incapacity to work compared to all general practitioners from the other 4 European countries (OR of 0.67 with 95% CI of 0.49-0.93).There are significant differences between assessments of incapacity to work in patients with SHC between countries and professional groups, but these differences are generally small. Potential explanations for these differences could be found in occupational and insurance medicine specialist training and in the existence of professional guidelines.

In dit onderzoek is het effect van invoering van evidence-based medicine (EBM) in de praktijk van bedrijfsartsen geevalueerd. De interventie bestond uit een EBM-cursus en een periode van vier maanden waarin bedrijfsartsen deelnamen aan tweewekelijkse gestructureerde patientenbesprekingen waarin zij hun eigen casuistiek en literatuurzoektochten bespraken. Elke maand waren de deelnemers verplicht om zoektochten in de literatuur te verrichten. Door middel van een gerandomiseerd en gecontroleerd onderzoek is het effect vier en zeven maanden na de start van de interventie gemeten. Uitkomstmaten waren toename van kennis en vaardigheden in EBM en zelfgerapporteerde toepassing van EBM. Daarnaast werd ook de kwaliteit van advies bij verzuimbegeleiding gemeten. Het bleek dat kennis en vaardigheden in EBM significant verbeterden, zowel direct na de interventieperiode als ook drie maanden later, vergeleken met de controlegroep. De kwaliteit van de adviezen bij verzuimbegeleiding verbeterde na twee maanden, maar na vier maanden zwakte het effect van de invoering van EBM op de adviezen af. Er werd geen effect gevonden op prognoseinschattingen van verzuimduur.

Evidence-based patientenbespreking is een nieuwe vorm van intercollegiaal overleg voor bedrijfsartsen.

Vragen van zowel werknemers als werkgevers rondom zwangerschap en werk komen regelmatig bij de bedrijfsarts terecht. Werknemers willen bijvoorbeeld advies in hoeverre het verantwoord is om door te blijven werken tijdens de zwangerschap in een bepaalde werkomgeving. Werkgevers hebben bijvoorbeeld algemene vragen over de preventie van werkgebonden risico’s ten aanzien van zwangerschap. Behalve de informatie die bedrijfsartsen krijgen van de zwangere zelf of haar behandelaar, wordt er van de bedrijfsarts verwacht dat hij of zij zelf voldoende up-to-date kennis heeft over dit onderwerp. Collega’s, specialisten, boeken, tijdschriften, cursussen, internet en intranetvoorzieningen zijn belangrijke informatiebronnen voor bedrijfsartsen.

Background: As a result of low numbers and diversity in study type, occupational health intervention studies are not easy to locate in electronic literature databases. Aim: To develop a search strategy that facilitates finding occupational health intervention studies in Medline, both for researchers and practitioners. Methods: A gold standard of articles was created by going through two whole volumes of 19 biomedical journals, both occupational health specialty and non-occupational health journals. Criteria for occupational health intervention studies were: evaluating an intervention with an occupational health outcome and a study design with a control group. Each journal was searched independently by two of the authors. Search terms were developed by asking specialists and counting word frequencies in gold standard articles. Results: Out of 11 022 articles published we found 149 occupational health intervention studies. The most sensitive single terms were work*[tw] (sensitivity 71%, specificity 88%) and effect*[tw] (sensitivity 75%, specificity 63%). The most sensitive string was (effect*[tw] OR control*[tw] OR evaluation*[tw] OR program*[tw]) AND (work*[tw] OR occupation*[tw] OR prevention*[tw] OR protect*[tw]) (sensitivity 89%, specificity 78%). The most specific single terms were "occupational health"[tw] (sensitivity 22%, specificity 98%) and effectiveness[tw] (sensitivity 22%, specificity 98%). The most specific string was (program[tw] OR "prevention and control"[sh]) AND (occupational[tw] OR worker*[tw]) (sensitivity 47%, specificity 98%). Conclusion: No single search terms are available that can locate occupational health intervention studies sufficiently. The authors' search strings have acceptable sensitivity and specificity to be used by researchers and practitioners respectively. Redefinition and elaboration of keywords in Medline could greatly facilitate the location of occupational health intervention studies.

De professionals in arbodiensten en UWV hebben een betere informatie-infrastructuur nodig omdat hoogwaardige kennis noodzakelijk is voor een betere kwaliteit van dienstverlening. Het gaat hierbij om de internationale literatuur op het terrein van arbeid en gezondheid en sociale zekerheid, de Nederlandse literatuur, richtlijnen, good practices, goede websites, juridische en educatieve informatie. In de huidige praktijk is de toegankelijkheid hiervan niet goed geregeld. Voorzieningen zoals bestaande intranetten van arbodiensten, zijn ontoereikend. De kloof met de wetenschappelijke wereld en met de technische mogelijkheden wordt snel groter. Arbodiensten en UWV lopen hierbij een risico van klachten en procedures betreffende de kwaliteit van de zorg en diensten. Een landelijke aanpak is nodig in aanvulling op noodzakelijke initiatieven van arbodiensten en UWV. In dit artikel wordt een schets gegeven van een infrastructuur met bijzondere aandacht voor een virtuele bibliotheek voor arbo en sociale zekerheid. Geadviseerd wordt dat arbodiensten, UWV, overheid en wetenschap de handen ineenslaan om op korte termijn betere voorzieningen te realiseren.