Quality assessment of occupational health services instruments.

Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be judged and improved. To judge quality aspects of instruments, a basic draft scheme and criteria are presented. A first category of criteria covers measurement objective and study design and comprises for example sample strategy and data aggregation level. Technical quality aspects are validity, reliability, standardization and precision. Acceptability of an instrument by employees, employers and professionals belongs to the process quality. At last, strategic quality or presumed utility has to be assessed. As an illustration four instruments have been judged: periodic occupational health surveys, pre-employment medicals, the company audit on work and health, and specific working conditions assessment instruments. Finally the presented basic scheme and criteria are brought into discussion.