To be seen, or not to be seen? Evaluating periodic occupational health screening

The doctoral thesis focuses on periodic occupational health screening: a regular medical examination of employees with exposure to occupational risks at the workplace. These periodic health screenings enable the occupational physicians to be in regular contact with a significant proportion of the working population (at least 70\% in Belgium) in a preventive medical setting, with the objective of early detection of health problems, advice towards risk-free behaviour, timely risk reductions or referrals to other care personnel. However, since a large number of employees needs to be seen yearly, it is also one of the most time consuming activities of the occupational physician. This is more and more difficult to reconcile with the shortage and persistent drop of occupational healthcare personnel. To this end, the first part of this PhD summarises the development and validation of an alternative form of periodic occupational health screenings: an electronic screening tool with an algorithm for selective follow-up. The tool was developed and validated using qualitative and quantitative methods, and its content validity, internal consistency, structural validity, and criterion validity was assessed and improved in multiple phases. Next, the PhD outlines a randomized controlled trial of periodic health screening in the Belgian hospital sector, wherein the effectiveness of the electronic screening tool was evaluated vis-à-vis a face-to-face health screening in the short term. In the control arm of the experiment, employees all had a face-to-face periodic health examination with the occupational physician. In the intervention arm, employees completed an electronic health screening survey, after which the worst scoring 20\% (i.e. the employees in the worst state of health according to the algorithm) were referred to the occupational physician for a consultation. As a secondary objective, the thesis explores several key methodological topics at the crossroads of occupational health and safety, its efficient organization and economic evaluation. It describes methodological challenges of economic evaluations in OHS, with a special focus on health-related productivity.

Publication year:2021

Accessibility:Open