The worksite can be a factor in the transmission of infectious diseases and an exposure source to workers. The use of infectious disease surveillance systems to identify work-related infectious diseases has not yet been assessed. The Michigan Department of Health and Human Services’ electronic infectious disease surveillance system includes text fields for “occupation/grade” and “worksite/school” for all health conditions. For some conditions, there is a separate section with checklists of specific risk factors, including work-related factors (e.g., healthcare worker, for tuberculosis cases). We examined the usefulness of occupation/worksite information in the text fields and risk factors sections of the infectious disease data system for identifying the occurrence of possible work-related infectious disease.
METHODS:
High risk occupations and industries associated with 32 infectious diseases with potential for work-relatedness were identified by a 2009 CSTE report after review of the medical literature. Data on confirmed and probable cases of these diseases in persons 16 years and older were extracted from the infectious disease registry for up to 13 years. The frequency with which occupation and worksite fields were completed was counted, information in the occupation/worksite fields was compared with the list of high-risk occupations/industries to determine if a high-risk occupation or worksite was identified, and information in the occupation/worksite fields was compared to information in the risk factors sections to identify discrepancies.
RESULTS:
Inclusion of occupation and worksite information in the text fields was variable, ranging from 54% (6/11 measles cases) to 3% (2/71 cases of Creutzfeldt- Jakob disease). Of the four conditions with the greatest numbers of cases annually, inclusion of occupation/worksite ranged from 31% (salmonellosis) to 26% (pertussis). The highest percentage matches between the high-risk occupation list and occupations listed in the text fields were for pertussis, Q fever, and brucellosis—all at 50%. There were many discrepancies between occupation/worksite information and information in the risk factor sections.
CONCLUSIONS:
Completeness of reporting of occupation and worksite information was highly variable; when included, the information identified some individuals where work may have been a risk factor based on a list of high-risk occupations/industries. Discrepancies between the occupation/worksite text fields and the risk factor sections indicate a need to improve data quality in order to better identify work-related disease. This study suggests that the collection of work-related information for some infectious diseases may be useful for identification of work-related infectious disease, especially if completeness and quality of work-related data are improved.