Abstract
OBJECTIVES: Registries are one strategy for collecting information on occupational exposure and disease in populations. Recently leaders in the Canadian occupational health and safety community have shown an interest in the use of occupational exposure registries. The primary goal of this study was to review a series of Canadian exposure registries to identify their strengths and weaknesses as a tool for tracking occupational exposure and disease in Canada. A secondary goal was to identify the features of an exposure registry needed to specifically contribute to prevention, including the identification of new exposure-disease relationships.
METHODS: A documentary review of five exposure registries from Canada was completed. Strengths and limitations of the registries were compared and key considerations for designing new registries were identified.
RESULTS: The goals and structure of the exposure registries varied considerably. Most of the reviewed registries had voluntary registration, which presents challenges for the use of the data for either surveillance or epidemiology. It is recommended that eight key issues be addressed when planning new registries: clear registry goal(s), a definition of exposure, data to be collected (and how it will be used), whether enrolment will be mandatory, as well as ethical, privacy and logistical considerations.
CONCLUSIONS: When well constructed, an exposure registry can be a valuable tool for surveillance, epidemiology and ultimately the prevention of occupational disease. However, exposure registries also have a number of actual and potential limitations that need to be considered.
Key Words: Registries, occupational exposure, exposure registries, surveillance
Résumé
OBJECTIFS: Les registres sont une stratégie possible pour recueillir de l’information sur les expositions professionnelles et les maladies dans des populations. Dernièrement, des chefs de file de la communauté canadienne de la santé et de la sécurité au travail se sont intéressés à l’utilisation des registres des expositions professionnelles. Le principal objectif de notre étude était d’examiner un ensemble de registres des expositions canadiens pour en cerner les forces et les faiblesses en tant qu’outils de localisation des expositions professionnelles et des maladies au Canada. L’objectif secondaire était de déterminer les caractéristiques nécessaires d’un registre des expositions pour qu’il contribue spécifiquement à la prévention, notamment à l’identification de nouveaux liens exposition-maladie.
MÉTHODE: Nous avons procédé à l’examen documentaire de cinq registres des expositions du Canada. Nous avons comparé les forces et les contraintes de ces registres et déterminé les principaux éléments à considérer pour concevoir de nouveaux registres.
RÉSULTATS: Les objectifs et la structure des registres des expositions variaient considérablement. L’inscription à la plupart des registres examinés était volontaire, ce qui complique l’utilisation des données à des fins de surveillance ou d’épidémiologie. Il est recommandé d’aborder huit questions clés en planifiant de nouveaux registres: la clarté de l’objectif ou des objectifs du registre; la définition de l’exposition; les données à recueillir; la façon dont elles seront utilisées; le caractère obligatoire (ou non) de l’inscription; l’éthique; la confidentialité; et la logistique.
CONCLUSIONS: Bien construit, un registre des expositions peut être un précieux outil de surveillance, d’épidémiologie et finalement de prévention des maladies professionnelles. Cependant, les registres des expositions ont aussi des contraintes réelles et potentielles dont il faut tenir compte.
Mots Clés: registres, exposition professionnelle, registres des expositions, surveillance
Footnotes
Conflict of Interest: None to declare.
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