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Trends in work-related respiratory diseases attributed to nickel, chromium and cobalt in the UK: descriptive findings from The Health and Occupation Research (THOR) network 1996–2019
  1. Ireny Y K Iskandar1,2,
  2. David J Gawkrodger3,
  3. Laura Byrne2,
  4. Matthew Gittins2,4,
  5. Melanie Carder2,
  6. David Fishwick2,3,5,
  7. Martie van Tongeren2
  1. 1 Division of Pharmacy & Optometry, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
  2. 2 Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research and Primary Care, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
  3. 3 Department of Infection, Immunology and Cardiovascular Disease, The University of Sheffield Medical School, Sheffield, UK
  4. 4 Centre for Biostatistics, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
  5. 5 Science and Research Centre, Health and Safety Executive, Derbyshire, UK
  1. Correspondence to Dr Ireny Y K Iskandar, Division of Pharmacy & Optometry, The University of Manchester Faculty of Biology Medicine and Health, Manchester M13 9PT, UK; ireny.iskandar{at}manchester.ac.uk

Abstract

Background Occupational exposure to metals can be associated with respiratory diseases which can adversely affect the individual’s health, finances and employment. Despite this, little is known about the incidence of these respiratory conditions over prolonged periods of time.

Aims This study aimed to investigate the trends in the incidence of work-related respiratory diseases attributed to nickel, chromium and cobalt in the UK.

Methods Cases of occupational respiratory diseases caused by nickel, chromium or cobalt reported to Surveillance of Work-related and Occupational Respiratory Disease (SWORD), the UK-based surveillance scheme between 1996 and 2019 (inclusive), were extracted and grouped into six 4-year time periods. Cases were characterised by causative metal exposure, occupational and industrial sector. Incidence rates diseases (adjusted for physician participation and response rate) were calculated using ONS employment data.

Results Of cases reported to SWORD during the study period, 1% (173 actual cases) of respiratory problems were attributed to nickel, chromium or cobalt. Diagnoses of asthma compromised the largest proportion of diagnoses (74.4%), followed by lung cancer (8.9%) and pneumoconiosis (6.7%). Cases had a mean age of 47 years (SD 13); 93% were men. The annual incidence fell from 1.6 per million employed in the first 4-year period, to 0.2 in the most recent period.

Conclusions Over 24 years, a decline in the incidence of metal-related occupational respiratory diseases was observed in the UK. This could be attributed to improvements in working conditions which resulted in reduced metal exposure but could also be due to closure of industries that might have generated case returns.

  • Epidemiology
  • Occupational Health
  • Nickel
  • Chromium
  • Cobalt

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • X @IrenyIskandar, @martievt

  • Contributors IYKI, DJG, MC, LB, DF and MvT contributed to the design, data collection, analysis and manuscript preparation. IYKI, DJG, MC, LB, DF and MvT have seen and agreed to the final manuscript.

  • Funding The Health and Occupation Research (THOR) network has been supported by grants from the Health and Safety Executive in the UK (contract number PRJ500). The funders/sponsors had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript or decision to submit the manuscript for publication. The information, views and opinion set out in this article are those of the authors and do not necessarily reflect the official view of the Health and Safety Executive or that of HSE policy makers.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.