Abstract:

Objective To summarize the practical experience of occupational health examination (OHE) quality assessment in Sichuan Province from 2020 to 2025, analyze the core challenges currently faced in quality control, and explore strategies to improve quality control effectiveness of quality control.

Methods Based on six consecutive years of quality assessment data from 330 registered OHE institutions in Sichuan Province, including centers for disease control and prevention (CDC)/occupational disease prevention institutes, public hospitals, and private medical institutions, a systematic analysis was conducted on comprehensive evaluation results and key technical indicators such as audiogram interpretation, pneumoconiosis chest X-ray quality and interpretation, blood lead testing, and chromosomal aberration analysis. Two rounds of cross-sectional comparisons were performed.

Results A total of 740 OHE institution visits were assessed over the six years. The overall compliance rate increased from 80.0% in 2020 to 81.5% in 2025, with a statistically significant improvement between the two rounds of assessment (P < 0.05). Compliance rates for audiogram interpretation and blood lead testing improved significantly between the two rounds (both P < 0.05). The type of OHE institution was an important determinant of quality outcomes; statistically significant differences of compliance rate among institution types were observed in the first round (P < 0.05), but the gap narrowed substantially in the second round. Chromosomal aberration analysis was currently the most critical technical weakness, with a compliance rate of only 39.7% in 2025. Additionally, the issues such as formalistic quality management systems, insufficient competency of chief physicians in charge of OHE, and low quality of information reporting were still quite prominent.

Conclusions A closed-loop quality control model, guided by problems, driven by assessments, and oriented by results, can effectively promote overall quality improvement among OHE institutions. It is recommended to further establish a closed-loop management system covering“registration-assessment-withdrawal”; implement a competency certification and credit scoring system for chief physicians in charge of OHE; launch targeted capacity-building initiatives for critical technical items; and advance intelligent and precision-based quality control measures in order to better safeguard workers’occupational health rights.