Key figures for occupational diseases in 2015

In 2014, the Netherlands Center for Occupational Diseases (NCvB) received and recorded 8,513 reports of occupational diseases out of a total of 950 occupational physicians working for 109 occupational health services, and 200 self-employed individuals. Both the number of physicians reporting occupational diseases and the number of occupational diseases reported have risen sharply compared with previous years.

This is probably the result of an investigation carried out by the Social Affairs and Employment Inspectorate and the Healthcare Inspectorate among occupational physicians on the reporting of occupational diseases. A stronger focus on reporting occupational diseases led to a sharp rise in the number of occupational diseases reported and the number of physicians reporting occupational diseases.

The occurrence of occupational diseases is reflected in the incidence per year, i.e., the number of new cases of occupational diseases reported in a particular year. Occupational physicians from the Intensive Notification Surveillance Project (PIM) reported 242 new cases of occupational diseases per 100,000 employees in 2014. The proportion of working individuals with a newly reported occupational disease in the total Dutch workforce in 2014 was 0.25%. This comes to an estimated 17,400 employees in 2014, which is similar to previous years.

Reports of occupational diseases relating to the musculoskeletal system, particularly shoulder problems, tennis elbows and chronic lower back pain, are particularly prevalent in the transport & storage and building sectors, in industry, and this year also in agriculture, forestry and fisheries, as well as in wholesale and retail. Mental occupational disorders are equally common among males and females. As in previous years, the vast majority of reports (74%) concerned diagnosed nervous exhaustion and burnout. In 57% of cases, absenteeism lasted longer than three months.

Contact dermatitis, particularly irritant contact dermatitis, is still the most commonly reported occupational skin disorder (72%). Most cases occur in the building sector (42%), followed by industry (23%) and the healthcare sector (16%).

The building sector, followed by industry and the healthcare sector, was also responsible for the majority of occupational respiratory disorders. Dust, plant-based products, bacteria and fibres account for more than 70% of the disorders reported.

Hearing disorder caused by occupational exposure to noise is still one of the most commonly reported occupational conditions in the Netherlands. Loss of hearing may lead to functional problems in situations where background noise is present and good hearing is required, even more so if impaired hearing is also causing side-effects such as tinnitus.

The two Solvents Teams in the Netherlands diagnosed 7 new cases of Chronic Toxic Encephalopathy (CTE), as opposed to 4 in the previous year. It is believed that the falling trend of the last 20 years can be put down to greater awareness of the harmful effects of organic solvents. This has led to a significant reduction in exposure in the Netherlands.

The three sectors with the highest number of reported occupational diseases are the curative healthcare sector (24%), the aviation sector (14%) and the building construction sector (11%). The incidence and prevalence of zoonotic infections in the Netherlands remain high, while the long-term disease burden resulting from zoonotic infections in the Netherlands is higher than initially assumed. 2014 saw a striking increase in the number of reported cases of leptospirosis (Weil's disease), 15 of which were contracted while at work.

The number of cases of occupational cancer reported to the NCvB continues to fall short of the estimated number of cases. Asbestos is still the main cause. Each year, there are 600 new cases of mesothelioma, and the end of this continuing rise is not in sight. In addition to asbestos, exposure to chromium trioxide (Cr(VI)) was also an important topic last year. Based on current medical literature, there is enough evidence to suggest a link between exposure to Cr(VI) and lung cancer, nasal cancer, allergic contact dermatitis, allergic occupational asthma, chrome ulcers and nasal septum perforation.

The NCvB has not received any reports of work-related effects on reproduction or the unborn child. However, in 2014, the pregnancy and work help desk received 24 questions: 15 questions about chemical substances, 7 about physical factors and 2 about exposure to biological agents.

Last year saw the publication of a new six-stage plan for occupational physicians for identifying, diagnosing, reporting and preventing occupational diseases. This six-stage plan was designed in association with the Netherlands Society of Occupational Medicine (NVAB). Those occupational physicians who had adopted the plan felt they were better equipped to substantiate their assessments. They also initiated more preventative activities. The stakeholders consulted (including representatives of insurance physicians, occupational hygienists, policy workers from the Ministries of Social Affairs & Employment (SZW) and Health, Welfare and Sport (VWS), the SZW Inspectorate, employers and trade unions) responded positively to the six-stage plan.