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An index case of occupational disease or injury is defined as the first ill or injured individual from a given workplace to receive medical care and thereby to draw attention to the existence of a workplace hazard and an additional workplace population at risk.A further purpose of case identification may be to assure that the affected individual receives appropriate clinical follow-up, an important consideration in view of the scarcity of clinical occupational medicine specialists (Markowitz et al. Finally, occupational health surveillance is an important means of discovering new associations between occupational agents and accompanying diseases, since the potential toxicity of most chemicals used in the workplace is not known.Foremost among the purposes of occupational health surveillance is to identify the incidence and prevalence of known occupational diseases and injuries.Gathering descriptive epidemiological data on the incidence and prevalence of these diseases on an accurate and comprehensive basis is an essential prerequisite for establishing a rational approach to the control of occupational disease and injury.Certain features characteristic of occupational disease exacerbate the difficulty of recognizing occupational diseases.With few exceptions—most notably, angiosarcoma of the liver, malignant mesothelioma and the pneumoconioses—most diseases that can be caused by occupational exposures also have non-occupational causes.Assessment of the nature, magnitude and distribution of occupational disease and injury in any geographic area requires a sound epidemiological database.

Public health surveillance refers to activities undertaken by federal, state or local governments within their respective jurisdictions to monitor and to follow up on occupational diseases and injuries.This non-specificity renders difficult the determination of the occupational contribution to disease occurrence.Indeed, the interaction of occupational exposures with other risk factors may greatly increase the risk of disease, as occurs with asbestos exposure and cigarette smoking.A medical surveillance programme applies tests and procedures on a group of workers with common exposures for the purpose of identifying individuals who may have occupational illnesses and for the purpose of detecting patterns of illness which may be produced by occupational exposures among the programme participants.Such a programme is usually undertaken under the auspices of the individuals employer or union.

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