PROPOSALS FOR EPIDEMIOLOGICAL SURVEILLANCE OF OCCUPATIONAL HEALTH IN AUSTRALIA

Summary Routine analyses of mortality and morbidity data can be used to develop and check causal hypotheses for a wide range of chronic diseases. However, it is rarely possible to pinpoint aetiological factors in the workplace through this means because the available job histories are not detailed enough, and there is a lack of information on exposures to suspect agents and possible confounders. There are special problems when disease latencies are long. Frequently, the benefits gained from surveillance programmes have been limited because the aetiological clues derived from them have not been tested in specific studies. It is therefore important that the allocation of resources reflect an appropriate balance between routine surveillance and specific studies. These studies should be as rigorous and thorough as the available resources permit. The resources allocated should depend on the level of suspicion and the potential attributable risk. To facilitate these studies, it is crucial that: Industries and unions do not destroy historic personnel records. Personal identifiers are sufficient to trace females as well as males in a national death index, clearing houses of morbidity information, and other record systems. Multiple causes of death are included in mortality data files. Exposure registers are developed when there are special concerns about hazardous effects. Confidentiality guidelines do not become unnecessarily restrictive.