[Quality and compliance with the regulations of workers'health examinations in relation to their preventive purpose].

OBJECTIVE

To analyze whether examinations for health surveillance in Catalonia are carried out with a high enough degree of quality as to comply with the preventive aim of the regulations, and to identify potential differences by type of prevention service.

METHOD: Qualitative and quantitative techniques. Body of data: Spanish regulations related to health surveillance, and a self-reported questionnaire answered by occupational health professionals who performed health examinations in their usual practice. Content analysis of regulations, identifying concepts, and linking them to survey questions. Quality criteria were established for each concept, referring to the minimum that must be met to ensure that the professional practice can be of quality; quality indicators (percentage of professionals whose practice met the quality criteria) were calculated globally and by type of prevention service; and quality standards (fulfilment of quality criteria by 75% or more of the professionals) were set.

RESULTS

The concepts identified were: availability of clinical and exposure information, job-specificity, identification of workers with special susceptibilities, referral to mutual insurance companies for appropriate diagnosis and treatment, development of preventive proposals, and professional independence and non detriment for workers. Quality indicators ranged between 0 and 88%. None of the concepts globally reached the quality standard.

CONCLUSIONS

The quality of health examinations performed for health surveillance in Catalonia, doesn't seem to be high enough as to comply with the preventive aim of the regulations. The situation is worse in external prevention services.