Interventions to increase the reporting of occupational diseases by physicians: a Cochrane systematic review

Background: Under-reporting of occupational diseases is an important issue in many countries. We conducted a Cochrane systematic review to evaluate the effectiveness of interventions aimed at increasing the reporting of occupational diseases by physicians.
\nMethods: We searched the Cochrane Occupational Safety and Health Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE, OSH UPDATE, Database of Abstracts of Reviews of Effects (DARE), Open-SIGLE, and Health Evidence up to January 2015. We intended to include randomised controlled trials (RCTs), cluster-RCTs, controlled before-after (CBA) studies, and interrupted time series (ITS) of the effects of increasing the reporting of occupational diseases by physicians. The results of similar studies were combined in a meta-analysis. 
\nResults: We included seven RCTs and five CBA studies. Six studies evaluated the effectiveness of educational materials alone, one study evaluated educational meetings, four studies evaluated a combination of the two, and one study evaluated a multifaceted educational campaign for increasing the reporting of occupational diseases by physicians. 
\nThere was moderate-quality evidence from two studies that the use of a personally addressed electronic newsletter describing the pros and cons of reporting occupational diseases did not increase the number of physicians reporting occupational diseases compared to no intervention with a risk ratio of 1.11 (95% confidence interval (CI) 0.74 to 1.67). 
\nDiscussion: The included studies provided evidence ranging from very low to moderate quality showing that educational materials, educational meetings, or a combination of the two did not considerably increase the reporting of occupational diseases.