Conflicts of Interest and Bias in Occupational Dermatology

Conflicts of interest, as defined by the Institute of Medicine, are a "set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest". Concern for the individual welfare of the patient, but also concern for the health status of a population or good research and teaching are considered to be the primary interests of physicians. Secondary interests are the economic interests of doctors and their employers, as well as recognition for professional achievements or the well-being of family and friends. The present review analyzes special problem areas in occupational dermatology in which specific conflicts of interest may arise. These are the prevention, diagnosis, and treatment of occupational skin diseases, expert opinions on behalf of accident insurance companies and social courts, but also guidelines and recommendations for the assessment of occupational skin diseases. As a medico-ethical maxim, it is recommended that occupational dermatologists should perceive and accept conflicts of interest as normal conditions of their professional behavior. When dealing with conflicts of interest, the transparency requirements of medical associations should be observed, as well as those of occupational accident insurance companies and social courts when providing expert opinions.