RT Journal Article
SR Electronic
T1 Population-based asbestosis surveillance in British Columbia
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 766
OP 771
DO 10.1136/oem.2008.045211
VO 66
IS 11
A1 W Q Gan
A1 P A Demers
A1 C B McLeod
A1 M Koehoorn
YR 2009
UL http://oem.bmj.com/content/66/11/766.abstract
AB Objectives: To investigate the use of multiple health data sources for population-based asbestosis surveillance in British Columbia, Canada.Methods: Provincial health insurance registration records, workers’ compensation records, hospitalisation records, and outpatient medical service records were linked using individual-specific study identifiers. The study population was restricted to individuals ⩾15 years of age living in the province during 1992–2004.Results: 1170 new asbestosis cases were identified from 1992 to 2004 for an overall incidence rate of 2.82 (men: 5.48, women: 0.23) per 100 000 population; 96% of cases were male and average (SD) age was 69 (10) years. Although the annual number of new cases increased by 30% during the surveillance period (β = 2.36, p = 0.019), the observed increase in annual incidence rates was not significant (β = 0.02, p = 0.398). Workers’ compensation, hospitalisation and outpatient databases identified 23%, 48% and 50% of the total new cases, respectively. Of the new cases, 82% were identified through single data sources, 10% were only recorded in the workers’ compensation records, and 36% only in each of the hospitalisation and outpatient records. 84% of hospitalisation cases and 83% of outpatient cases were not included in the workers’ compensation records. The three data sources showed different temporal trends in the annual number of new cases and annual incidence rates.Conclusions: Single data sources were not sufficient to identify all new cases, thus leading to serious underestimations of the true burden of asbestosis. Integrating multiple health data sources could provide a more complete picture in population-based surveillance of asbestosis and other occupational diseases.