AbstractBackgroundOccupational diseases are generally underreported. The aim of this study was to evaluate whether a sentinel surveillance project comprising motivated and guided occupational physicians would provide higher quality information than a national registry for a policy to prevent occupational diseases.MethodsA group of 45 occupational physicians participated in a sentinel surveillance project for two years. All other occupational physicians (N = 1,729) in the national registry were the reference group. We compared the number of notifications per occupational physician, the proportion of incorrect notifications, and the overall reported incidence of occupational diseases.ResultsThe median number of notifications per occupational physician during the project was 13.0 (IQR, 4.5–31.5) in the sentinel group versus 1.0 (IQR, 0.0–5.0) in the reference group (P < 0.001). The proportion of incorrect notifications was 3.3% in the sentinel group and 8.9% in the reference group (P < 0.001). The overall reported occupational disease incidence was 7 times higher (RR = 6.9, 95% CI: 6.5–7.4) in the sentinel group (466 notifications per 100,000 employee years) than in the reference group (67 notifications per 100,000 employee years).ConclusionsA sentinel surveillance group comprising motivated and guided occupational physicians reported a substantially higher occupational disease incidence and a lower proportion of incorrect notifications than a national registry. Am. J. Ind. Med. 51:834‐842, 2008. © 2008 Wiley‐Liss, Inc.