Incidence by occupation and industry of acute work related respiratory diseases in the UK, 1992–2001
- 1National Heart & Lung Institute, Imperial College School of Medicine, London, UK
- 2Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
- 3Department of Public Health Sciences, University of Alberta, Edmonton, Canada
- Correspondence to: Professor J C McDonald Imperial College School of Medicine, National Heart & Lung Institute, Occupational and Environmental Medicine, Dovehouse Street, London SW3 6LY, UK;
- Accepted 18 May 2005
Aims: To summarise incidence rates and epidemiological characteristics of new cases of work related respiratory disease reported by specialist physicians in thoracic and occupational medicine, with particular reference to occupation, industry, and causal agents for asthma, inhalation accidents, and allergic alveolitis.
Methods: Cases reported 1992–2001 to the SWORD and OPRA national surveillance schemes, in which almost all UK chest and occupational physicians participate, were analysed by age, sex, cause, occupation, and industry, with incidence rates calculated against appropriate denominators.
Results: Excluding diseases of long latency, infrequently seen by occupational physicians, the distribution of diagnoses in the two specialties was similar, but with rates generally much higher in occupational than chest physicians. Occupational asthma was responsible for about 25% of cases overall, affecting mainly craft related occupations and machinists, and most often attributed to isocyanates, metals, grains, wood dusts, solders, and welding fume. These same occupations were those at highest risk from inhalation injuries, most frequently caused by irritant gases, vapours, and fume. Among medical technicians and nurses, however, glutaraldehyde and latex were the main causes of occupational asthma. Allergic alveolitis was seldom reported, with almost all cases in agriculture, forestry, and fishing.
Conclusion: During the 10 year period studied, there were few changes in level of reported incidence, apart from some decline in occupational asthma and inhalation injuries. These results and their implications should be distinguished from much higher estimates of asthma made worse by work derived from population surveys, based on prevalence rather than incidence, and self-reported symptoms rather than diagnoses made by specialist physicians. Even so, the reported incidence of new cases of acute respiratory illness caused by work remains substantial.
- BTS, British Thoracic Society
- LFS, Labour Force Survey
- ODIN, Occupational Disease Intelligence Network
- OPRA, Occupational Physicians Reporting Activity
- SIC, Standard Industrial Classification
- SOC, Standard Occupational Classification
- SOM, Society of Occupational Medicine
- SWORD, Surveillance of Work-related and Occupational Respiratory Disease
Competing interests: none