The implementation of workers’ health surveillance by occupational physicians

Work can have a positive influence on health of workers, but can also negatively affect workers’ health, leading to impaired work functioning or sickness absence. Workers’ health surveillance (WHS) is a preventive strategy aimed at primary and secondary prevention of work-related health problems. WHS consists of screening on work-related health risks early on, and implementation of preventive measures if necessary. However, WHS has not been implemented regularly by occupational physicians (OPs) in the Netherlands.
The aim of this thesis was to gain knowledge on the implementation of, and on how to improve the implementation of WHS by OPs.
In part 1 of this thesis, a four-year cohort study among OPs in the Netherlands showed that WHS was not implemented regularly, while knowledge and skills level, motivation of OPs and opportunities in the environment were predictive for the implementation of WHS. An interview study among managers of occupational health services showed that some managers had a positive view on WHS, while the policy was not actively promoting WHS to companies.
In part 2 of this thesis, a WHS training programme for OPs was developed. A randomized controlled trial showed that self-efficacy level and skills level increased after training, while knowledge level did not change. Evaluation of a second WHS mental health module training programme in a pre-post design showed that self-efficacy and motivation level increased, while knowledge did not change. Participants of both training programmes were satisfied with the training programme. Finally, the results of the fourth survey in the cohort showed that three months after training, no change in knowledge and skills level of OPs was found.
It can be concluded that WHS was not implemented regularly by OPs, and knowledge, skills, motivation, and opportunities were predictive factors. A WHS training programme did increase knowledge and skills level immediately after training.