Review on the validity of self-report to assess work-related diseases

Self-report is an efficient and accepted means of assessing population characteristics, risk factors, and diseases. Little is known on the validity of self-reported work-related illness as an indicator of the presence of a work-related disease. This study reviews the evidence on (1) the validity of workers' self-reported illness and (2) on the validity of workers' self-assessed work relatedness of an illness. A systematic literature search was conducted in four databases (Medline, Embase, PsycINFO and OSH-Update). Two reviewers independently performed the article selection and data extraction. The methodological quality of the studies was evaluated, levels of agreement and predictive values were rated against predefined criteria, and sources of heterogeneity were explored. In 32 studies, workers' self-reports of health conditions were compared with the "reference standard" of expert opinion. We found that agreement was mainly low to moderate. Self-assessed work relatedness of a health condition was examined in only four studies, showing low-to-moderate agreement with expert assessment. The health condition, type of questionnaire, and the case definitions for both self-report and reference standards influence the results of validation studies. Workers' self-reported illness may provide valuable information on the presence of disease, although the generalizability of the findings is limited primarily to musculoskeletal and skin disorders. For case finding in a population at risk, e.g., an active workers' health surveillance program, a sensitive symptom questionnaire with a follow-up by a medical examination may be the best choice. Evidence on the validity of self-assessed work relatedness of a health condition is scarce. Adding well-developed questions to a specific medical diagnosis exploring the relationship between symptoms and work may be a good strateg

Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure

Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool - Nordic Occupational Skin Questionnaire (NOSQ-2002) - for surveys on work-related skin disease and exposures to environmental factors. The 2 NOSQ-2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ-2002/SHORT is a ready-to-use 4-page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ-2002/SHORT) are included in the long version, NOSQ-2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ-2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ-2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ-2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries

Nordic Occupational Skin Questionnaire - NOSQ

Questionnaires for surveying work-related skin diseases and exposures have been designed in the Nordic Occupational Skin Questionnaire (NOSQ) project. NOSQ-2002/SHORT is a short, ready-to-use questionnaire for screening and monitoring occupational skin diseases on hands and forearms. NOSQ-2002/LONG is a longer, more in-depth questionnaire for surveying hand dermatitis and risk factors in workplaces or in a population. The Nordic Council of Ministers has the copyright to the NOSQ-2002 questionnaires. Use of the questionnaires is free of charge. The NOSQ-2002 questionnaires and their present and possible future translations cannot be used commercially. The NOSQ-2002 report includes a review of pertinent literature on questionnaire methods for skin disease studies and the NOSQ-2002/INFO version of the questionnaire including instructions and recommendations to researchers and guidelines for modification

Does method of selecting starting dose affect efficacy of narrow-band ultraviolet B phototherapy for psoriasis?

Clinical decision-making is a complex process. It involves interaction of various clinical and nonclinical factors. The literature regarding this subject in non-dermatological specialities is expanding.1 However, in dermatology little is known about this process.2 The aim of this study was to explore common management decisions made in dermatology outpatient clinics and the main influences on these decisions. The investigator (FMH) observed the consultations of patients at a university hospital dermatology outpatient clinic. Verbatim notes were taken of the conversations between the clinicians and the patients. Inferences were drawn regarding different management decisions taken during these consultations and the possible factors influencing these decisions. 217 consultations (consultants¼66.8%, specialist registrars¼25.8%, clinical lecturers¼4.1%, clinical nurse specialists¼3.2%) were observed. The mean duration of the consultations was 11 minutes (SD¼6.99) with a significant difference between the consultation times for different clinicians (Po0.0001). The most frequently made decisions included: carrying out laboratory investigations (28.6%), starting new topical treatment (22.1%), discharge to primary care (17.5%), renewal of systemic medication (16.1%), and renewal of topical medication (12%). A total of 19 clinical and non-clinical factors influencing these decisions were identified. More frequent clinical factors included: clinical guidelines (32.7%), deterioration of skin condition (21.2%), improvement of skin condition (20.7%), and side effects of medications (10.6%). More frequent non-clinical factors included: patient’s treatment preferences (9.7%), patient’s concerns (6.9%), quality of life issues (6.5%), patient’s time commitment (6.5%), and treatment compliance problems (4.6%). In this study we have identified the types of management decisions taken in dermatology and the main influences on these decisions. Studying the link between clinical decisions and the influences on these decisions will contribute to better understanding of decision making processes in dermatology, on which better health outcomes depend. [1] Cook SA, Rosser R, James MI et al. (2007) Factors influencing surgeons’ decisions in elective cosmetic surgery consultations. Med Decis Making 27:311–20. [2] Katugampola RP, Hongbo Y, Finlay AY (2005) Clinical management decisions are related to the impact of psoriasis on patient-rated quality of life. Br J Dermatol 152:1256–62

An epidemic of furniture-related dermatitis: searching for a cause

P>Background Sitting in new chairs or sofas has elicited dermatitis in numerous patients in Finland and in the U.K. since autumn 2006. The cause of the dermatitis seemed to be an allergen in the furniture materials. Objectives To determine the cause of the dermatitis in patients with furniture-related dermatitis. Methods Altogether 42 patients with furniture-related dermatitis were studied. First, 14 Finnish patients were patch tested with the standardized series and with the chair textile material. A thin-layer chromatogram (TLC) strip and an extract made from the same textile material were tested in seven Finnish patients. The test positive spot of the TLC and the content of a sachet found inside a sofa in the U.K. were analysed by using gas chromatography-mass spectrometry. All chemicals analysed were patch tested in 37 patients. Results A positive patch test reaction to the chair textile and to its extract was seen in all patients tested, one-third of whom had concurrent reactions to acrylates. Positive reactions to the same spot of the TLC strip were seen in five of seven patients and dimethyl fumarate was analysed from the spot as well as from the sachet contents. Dimethyl fumarate (0 center dot 01%) elicited positive reactions in all the patients. The other chemicals analysed did not elicit positive reactions, but one patient in the U.K. had a positive reaction to tributyl phosphate. Conclusions Sensitization to dimethyl fumarate was seen in all the patients with furniture-related dermatitis. Concurrent sensitization or cross-reactions were common among the sensitized patients