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Mortality from diabetes and ischaemic heart disease in textile workers
  1. Francesca Zanardi1,
  2. E Clare Harris2,
  3. Terry Brown3,
  4. Simon Rice4,
  5. Keith T Palmer2,
  6. David Coggon2
  1. 1Occupational Medicine Unit, Alma Mater Studiorum, University of Bologna, Bologna, Italy
  2. 2MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK
  3. 3Institute of Environment and Health, Cranfield University, Cranfield, UK
  4. 4Mathematical Sciences Unit, Health and Safety Laboratory, Buxton, UK
  1. Correspondence to Professor David Coggon, MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; dnc{at}


Background To explore explanations for elevated mortality from diabetes among male garment manufacturers and repairers in England and Wales during 1979-1990, analysis was extended by 10 years, looking also at other textile workers and at deaths from ischaemic heart disease (IHD).

Methods Data on some 3.5 million deaths were used to compute proportional mortality ratios (PMRs) for diabetes and IHD, standardised for age and social class, in 10 textile-associated job groups, with additional analyses by place of birth for 1993–2000.

Results Male mortality from diabetes was elevated in nine of the 10 textile jobs, with overall PMRs of 147 (95% CI 131 to 165) during 1979–90 and 170 (95% CI 144 to 199) during 1991–2000. Proportional mortality from IHD was also consistently high. Female mortality from both diseases was close to that for other occupations. In both sexes, mortality from diabetes and IHD was increased among people born in the Indian subcontinent (PMRs 353 and 139 in men; 262 and 130 in women). In men, the proportion of deceased textile workers born in the Indian subcontinent (11.4%) was much higher than for all occupations (1.8%), but not in women (1.1% vs 0.7%). PMRs for male textile workers standardised for place of birth were lower but still significantly elevated (133, 95% CI 110 to 159 for diabetes; 109, 95% CI 105 to 114 for IHD).

Conclusions No obvious occupational hazard explains the increased risk specific to men across a wide range of textile occupations. One possible explanation is uncontrolled residual confounding related to place of birth. This could be tested through suitably designed morbidity surveys.

  • Mortality
  • occupation
  • diabetes
  • ischaemic heart disease
  • textile workers
  • India
  • immigrants
  • cardiovascular
  • Diabetes mellitus
  • mortality studies

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  • Funding The Health and Safety Executive provided financial support for analytical work carried out by the Health and Safety Laboratory. Clare Harris was supported by the Colt Foundation.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.