IDENTIFICATION AND PREVENTION OF WORK-RELATED DISEASES AND PREMATURE INCAPACITY

In many cases, the increasing knowledge about the causes of occupation al diseases has led to improved preventive actions at the working plac e. This made it possible to achieve a general decrease in the incidenc e of occupational diseases - except for some illnesses such as asbesto s-related and obstructive lung diseases. An opposite trend can be noti ced in the field of work-related illnesses, which especially includes cardiovascular, psychiatric and psychovegetative diseases, and musculo skeletal disorders. In contrast to the occupational diseases, in this context work factors are only of less importance and interact with int rapersonal, social and environmental aspects. Since the associations b etween the working world and the disease are normally too weak due to the multiple causes involved, what is therefore required for researchi ng these multifactorial relationships are most sensitive epidemiologic al examination methods including large populations and at the same tim e avoiding or controlling bias and confounding. Most of the recent stu dies are based on secondary evaluations of already existing data (prem ature incapacity, inability to work, results from special preventive c hecks at the working place). Although this leads to large populations, a considerable bias is caused at the same time since these data in mo st cases are collected for administrative purpose rather than for epid emiological reasons. Moreover, when looking at the different load fact ors, only the work aspects are mainly taken into consideration, which leads to considerable confounding due to the omitted other concurring causes. Thus, most of the associations discovered so far are not stron g enough to allow for a general deduction of special preventive measur es at the working place. For further investigation of these relationsh ips, prospective cohort and intervention studies are therefore require d.