The aim of this study was to estimate costs of illness resulting from specific occupational lung and skin diseases caused by isocyanates in Europe.

First, we conducted a comprehensive systematic literature search in selected databases from the German Institute for Medical Documentation and Information (DIMDI) and the OSH Reference database to identify articles dealing with costs of illness as well as indicators of severity/duration of occupational lung and skin diseases and evaluated the quality of included studies. A detailed quality evaluation was carried out for all included studies with the support of quality assessment instruments. Second, we analysed aggregated claim data provided by the German Social Accident Insurance (DGUV) covering costs for medical rehabilitation, services for professional rehabilitation and pensions for the years 2004-2013. Third, we transferred both, costs of illness values identified through the systematic literature search as well as calculated costs of illness based on claims data analysis, to the EU-28 countries using different methodological approaches.

According to data from the DGUV, approximately 500 insured persons per year with recognised occupational lung disease and approximately 20 insured persons with recognised occupational skin disease used at least one service per year for medical rehabilitation, service for professional participation or pension. Per case of disease of an insured person average total costs of almost €9000 per year for lung diseases (BK1315), and approximately €7000 per year for skin diseases (BK-5101) caused by isocyanates over 2004-2013 were calculated. A share of about 20% of these average total costs can be attributed to the cost category "medical rehabilitation".

The cost of illness data derived by claim data analysis and literature search was extrapolated to EU-28, and average costs per case of disease and year were calculated. In this extrapolation only medical rehabilitation costs and productivity losses were included. The extrapolation lead to a range of costs depending on the data sources used and methodological approaches applied: 2.100€ to 3.500€ per case of occupational asthma, and 1.800€ to 2.400€ per case of occupational contact dermatitis.