7 million), selleck chemicals llc benefit from comprehensive occupational health support. About half of the workforce undergoes an annual health examination and another fifth has an assessment every 3 or 5year. The content of the periodical health surveillance including the use of specific clinical tests is based on some legal requirements and is not underpinned by any sound evidence. Occupational health is completely financed by the employers and depends largely on the total number of health assessments. Like in many other countries, there are too few occupational physicians and the active ones are under pressure to perform all the clinical examinations instead of providing hazard definition and measurements, risk management, health and safety information and training.

The number of physicians working in Belgian occupational health services (OHS) is estimated at 1100 (800 full-time equivalents), giving 30 (22 FT) OPs per 100.000 workers or an understaffing of 30%. There are no readily obtainable comparable data, but Nicholson presented a crude guide to the diversity of access to OPs within Europe, ranging from 5 physicians per 100.000 in the UK to 61 physicians per 100.000 workers in Finland [11]. In this context, evidence-based occupational medicine is not considered a priority and Belgium is lagging behind in the development and implementation of EBM in the occupational health setting. While the Netherlands and the United Kingdom have published several evidence-based and clinical practice guidelines, only recently a first recommendation, concerning job-related fitness tests for firemen, was developed by a Belgian expert panel [12-14].

To obtain some insight to what extent Belgian OPs integrate evidence in their medical decisions during consultation, we gathered data and information on one routine activity in occupational health surveillance, in particular urinalysis. Although the screening of all workers at pre-employment and annual health examinations for albumin and glucose in urine is no longer a legal requirement (Publication in 2003 of the Belgian Royal Decree on health surveillance of workers), dipstick testing is still common in daily practice. Dipstick urinalysis is simple and quick to perform, has no morbidity (other than sometimes labelling a healthy person as sick), and is among the most commonly performed screening tests [15,16].

However, whether physicians should routinely screen for haematuria and proteinuria in asymptomatic persons Entinostat is a point at issue [15-18]. The most common causes for haematuria in adults include urinary tract infections, urolithiasis and urological malignancy. For the detection of haematuria, the specifity of a heme dipstick positive at 1+ or greater has been reported as 65.0% to 99.3% when microscopic haematuria is used as the golden standard. Heavy exercise or prolonged recumbency can produce haematuria in normal adults.