ArticleInternational archives of occupational and environmental health2004
Evaluation of the effectiveness of pre-employment screening.
Article in International archives of occupational and environmental health, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Pre-employment examinations for preventing injury, disease and sick leave in workers.The Cochrane database of systematic reviews · 2016Pooled it
- Criteria and methods used for the assessment of fitness for work: a systematic review.Occupational and environmental medicine · 2007Pooled it
- Exposure to Polycyclic Aromatic Hydrocarbons, but Not to Dust or Fluorides, in the Norwegian Aluminum Industry Is Associated With Accelerated Annual Decline in Lung Function.American journal of industrial medicine · 2026Article
- Pre-employment examination for low back risk in workers exposed to manual handling of loads: French guidelines.International archives of occupational and environmental health · 2016Article
- Respiratory disorders in aluminum smelter workers.Journal of occupational and environmental medicine · 2014Review
- Factors affecting mental fitness for work in a sample of mentally ill patients.International journal of mental health systems · 2009Article
- Evaluation of medical decisions' effectiveness: a 4-year evidence-based study in a health care setting.International archives of occupational and environmental health · 2008Article
- Agreement of medical decisions in occupational health as a quality requirement.International archives of occupational and environmental health · 2006Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimAs pre-employment screening and selection is a main function in the protection of susceptible applicants from developing an occupational disease, we need insight into the effectiveness of this intervention under different exposure conditions. The aim of our study was to demonstrate the feasibility and usefulness of three indicators to evaluate the effectiveness of pre-employment examinations.
methodWe used a pre-employment medical evaluation table to gather the data needed for the indicators for effectiveness. The first indicator chosen is the predictive value of a positive test result (PPV) corresponding to the percentage of applicants who will develop an occupational disease after a positive test result. The second indicator is the number of pre-employment medical examinations needed to reduce the number of new cases of an occupational disease by one (number needed to test, NNT). The third is the number of rejections for the job, as the consequence of a positive test result, needed to reduce the number of new cases of an occupational disease by one (number needed to reject, NNR). To illustrate feasibility and usefulness, we used the example of potroom asthma in the primary-aluminium industry. We used data on personal risk factors and on the incidence of potroom asthma from a nested case-control study in the Netherlands.
resultsThe three indicators for effectiveness could be applied. For high incidence rates, defined as 0.04 (40 cases/1000 employees per year), the PPV values for personal risk indicators varied from 5% to 27%. The NNT varied from 116 to 667. Finally, the NNR varied from 4 to 20. For low incidence rates, defined as 0.005 (5 cases/1000 employees per year), the PPV values were low (0.6% to 5%). The NNT were high (1111 to 5000). The NNR varied from 23 to 155.
conclusionThe three indicators for effectiveness are applicable under the condition of the availability of relevant empirical data. The indicators provided useful information for the evaluation of the effectiveness of specific tests, which might be added as selection criteria. The personal risk factors studied were far from effective as selection instruments, especially in situations where a low incidence of potroom asthma exists. Personal risk factors at the pre-employment stage should not be added to the standard procedure to select susceptible applicants. Under conditions, they may be taken into account in a workers' health surveillance programme. As a contribution to evidence-based occupational medicine, we recommend the use of the pre-employment medical evaluation table and the three chosen indicators for effectiveness as a standard tool to evaluate the effectiveness of pre-employment medical examinations.
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