Occupational and Environmental Medicine最新文献

{"title":"Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula.","authors":"Alexander Keil, Gregory Haber, Barry Graubard, Patricia A Stewart, Debra Silverman, Stella Koutros","doi":"10.1136/oemed-2024-109532","DOIUrl":"10.1136/oemed-2024-109532","url":null,"abstract":"<p><strong>Objectives: </strong>To inform the potential human carcinogenicity of acrylonitrile, we estimate associations between acrylonitrile exposures and lung cancer mortality in US workers with the objectives of (1) assessing potential for healthy worker survivor bias and (2) adjusting for this bias while assessing the expected lung cancer mortality under different hypothetical occupational exposure limits on acrylonitrile exposure using the parametric g-formula.</p><p><strong>Methods: </strong>We used data from a cohort of 25 460 workers at facilities making or using acrylonitrile in the USA. We estimated HRs to quantify associations between employment and lung cancer mortality, and exposure and leaving employment. Using the parametric g-formula, we estimated cumulative lung cancer mortality at hypothetical limits on acrylonitrile exposure.</p><p><strong>Results: </strong>Recent and current employment was associated with lung cancer, and exposure was associated with leaving employment, indicating potential for healthy worker survivor bias. Relative to no intervention, reducing the historical exposure under limits of 2.0, 1.0 and 0.45 parts per million would have been expected to reduce lung cancer mortality by age 90 by 4.46 (95% CI 0.78 to 8.15), 5.03 (95% CI 0.96 to 9.11) and 6.45 (95% CI 2.35 to 10.58) deaths per 1000 workers, respectively. A larger lung cancer mortality reduction would be expected under elimination of exposure: 7.21 (95% CI 2.72 to 11.70) deaths per 1000 workers.</p><p><strong>Conclusions: </strong>Healthy worker survivor bias likely led to underestimation of excess risk. Our results corroborate previous study findings of an excess hazard of lung cancer among the highest exposed workers.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"225-231"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of birth weight and perfluorohexane sulfonate exposures: examination of sample timing and study confidence.","authors":"Hongyu Ru, Alexandra L Lee, Kristen M Rappazzo, Michael Dzierlenga, Elizabeth Radke, Thomas F Bateson, J Michael Wright","doi":"10.1136/oemed-2023-109328","DOIUrl":"10.1136/oemed-2023-109328","url":null,"abstract":"<p><p>We examined the association between mean birth weight (BW) differences and perfluorohexane sulfonate (PFHxS) exposure biomarkers.We fit a random effects model to estimate the overall pooled effect and for different strata based on biomarker sample timing and overall study confidence. We also conducted an analysis to examine the impact of a continuous measure of gestational age sample timing on the overall pooled effect.We detected a -7.9 g (95% CI -15.0 to -0.7; p_Q=0.85; I²=0%) BW decrease per ln ng/mL PFHxS increase based on 27 studies. The 11 medium confidence studies (β=-10.0 g; 95% CI -21.1 to 1.1) showed larger deficits than 12 high (β=-6.8 g; 95% CI -16.3 to 2.8) and 4 low confidence studies (β=-1.5 g; 95% CI -51.6 to 48.7). 10 studies with mid-pregnancy to late-pregnancy sampling periods showed smaller deficits (β=-3.9 g; 95% CI -17.7 to 9.9) than 5 post-partum studies (β=-28.3 g; 95% CI -69.3 to 12.7) and 12 early sampling studies (β=-7.6 g; 95% CI -16.2 to 1.1). 6 of 12 studies with the earliest sampling timing showed results closer to the null.Overall, we detected a small but statistically significant BW deficit across 27 studies. We saw comparable BW deficit magnitudes in both the medium and high confidence studies as well as the early pregnancy group. Despite no definitive pattern by sample timing, larger deficits were seen in postpartum studies. We also saw results closer to the null for a subset of studies restricted to the earliest biomarker collection times. Serial pregnancy sampling, improved precision in gestational age estimates and more standardised reporting of sample variation and exposure units in future epidemiologic research may offer a greater understanding of the relationship between PFHxS on BW and any potential impact of pregnancy haemodynamics.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"266-276"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects on household income and earnings from chronic kidney disease of non-traditional origins: PREP project findings from Chichigalpa, Nicaragua.","authors":"Heath Prince, Thomas Boswell, Jason Glaser, Catharina Wesseling, Ashweeta Patnaik, William Martinez-Cuadra","doi":"10.1136/oemed-2023-109163","DOIUrl":"10.1136/oemed-2023-109163","url":null,"abstract":"<p><strong>Objective: </strong>Our purpose with this study is to examine the socioeconomic outcomes associated with chronic kidney disease not related to well-known risk factors (CKDnt) in four communities in Chichigalpa, Nicaragua that are home to a substantial number of sugarcane workers.</p><p><strong>Methods: </strong>We employed a cluster-based systematic sampling design to identify differences in outcomes between those households affected directly by CKDnt and those that are not.</p><p><strong>Results: </strong>Overall, we find that approximately one-third of households surveyed had a household member diagnosed with CKDnt. 86% of CKDnt households reported that the head of the household had been without work for the last 6 months or more, compared with 53% of non-CKDnt households. Non-CKDnt households took in more than double the earnings income on average than CKDnt households ($C52 835 and $C3120, respectively). Nonetheless, on average, CKDnt households' total income exceeded that of non-CKDnt households due to Nicaragua's national Instituto Nicaraguense de Seguridad Social Social Security payments to CKDnt households, suggestive of a substantial economic burden on the state resulting from the disease. Households headed by widows or widowers who are widowed as a result of CKDnt demonstrate distinct deficits in total income when compared with either non-widowed households or to households widowed by causes other than CKDnt.</p><p><strong>Conclusions: </strong>Despite strong similarities in terms of demographic characteristics and despite residing in the same communities with similar access to the available resources, households experiencing CKDnt exhibit distinct and statistically significant differences in important socioeconomic outcomes when compared to non-CKDnt households.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"258-261"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional demands at work and risk of disability pension: a nationwide cohort study in Denmark","authors":"Elisabeth Framke, Jeppe Karl Sørensen, Ida E H Madsen, Reiner Rugulies","doi":"10.1136/oemed-2023-109378","DOIUrl":"https://doi.org/10.1136/oemed-2023-109378","url":null,"abstract":"Introduction Working in emotionally demanding jobs is associated with an increased risk of temporarily leaving the labour market due to long-term sickness absence. We tested whether employees working in emotionally demanding jobs are also at higher risk of permanently leaving the labour market due to disability pension compared with employees working in jobs that are not emotionally demanding. Methods We conducted a 10-year cohort study in the workforce in Denmark (n=1 670 825), aged 30–59 years at baseline, by linking job exposure matrices with nationwide registries on social transfer payments and covariates. Using Cox regression, we analysed the risk of disability pension in relation to emotional demands in the full population and sex stratified. Multivariable adjusted models included sex, age, cohabitation, migration background, household disposable income and other work environmental factors (physical workload, influence, possibilities for development and role conflicts). Results We identified 67 923 new cases of disability pension during 15 649 743 person-years of follow-up (mean follow-up: 9.4 years). We found an increasing risk of disability pension with higher levels of emotional demands, with HRs of 1.20, 1.23 and 1.73 for medium-low, medium-high and high emotional demands, respectively, compared with low emotional demands in the most adjusted model. There was an exposure–response association in women and a tendency towards an exposure–response association in men. Discussion In this nationwide cohort study, we found an increased risk of permanent exit from the labour market due to disability pension in women and men working in emotionally demanding jobs. Data are available on reasonable request. The data underlying this article cannot be shared publicly due to data protection regulation. All data are stored in a protected server environment at Statistics Denmark and can be accessed only by researchers who are authorised by Statistics Denmark and approved by the National Research Centre for the Working Environment. Please, contact RR for details (rer@nfa.dk).","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":"81 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140887051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational injuries caused by fire and smoke in Victoria, Australia, 2003–2021: a descriptive study","authors":"Janneke Berecki-Gisolf, Win Wah, Karen Walker-Bone","doi":"10.1136/oemed-2024-109428","DOIUrl":"https://doi.org/10.1136/oemed-2024-109428","url":null,"abstract":"Objectives Hospital attendance related to fire, flame or smoke exposure is commonly associated with work. The aim of this study was to examine time trends and risk factors for work-related fire/flame/smoke injuries in Victoria, Australia. Methods This study was based on emergency department (ED) presentation records from the Victorian Emergency Minimum Dataset, 2003–2021. Cases were people aged 15–74 years with injury-related ED presentations, if cause of injury was recorded as fire/flame/smoke, based on coded data and/or narratives. Work-related rates were calculated per employed persons; non-work rates were calculated per population. Work-related and non-work-related cases were compared using logistic regression modelling. Results There were 11 838 ED presentations related to fire/flame/smoke: 1864 (15.7%) were work-related. Non-work-related rates were 12.3 ED presentations per 100 000 population , and work-related rates were 3.43 per 100 000 employed persons annually. Over the study period, work-related rates decreased annually by 2.0% (p<0.0001), while non-work rates increased by 1.1% (p<0.0001). Work-related cases (vs non-work) were associated with summer (vs winter), but the association with extreme bushfire periods (Victorian ‘Black Saturday’ and ‘Black Summer’) was not statistically significant. Work-related cases were less severe than non-work-related cases, evidenced by triage status and subsequent admission. Conclusions Rates of occupational fire/flame/smoke-related injury presentations decreased over the past two decades in Victoria, while non-work-related rates increased. This could reflect improved safety in the workplace. Hospital data, however, cannot be used to distinguish occupation or industry therefore, employment data linkage studies are recommended to further inform workplace preventive measures. Data may be obtained from a third party and are not publicly available.","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":"63 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of workplace violence: descriptive results from the National Transgender Discrimination Survey.","authors":"Idia Enogieru, Ashley L Blewitt-Golsch, Lauren J Hart, Sara LeGrand, Kathryn Whetten, Truls Ostbye, Candice Y Johnson","doi":"10.1136/oemed-2023-109197","DOIUrl":"10.1136/oemed-2023-109197","url":null,"abstract":"<p><strong>Objective: </strong>To describe the lifetime prevalence of workplace harassment, physical violence and sexual assault against transgender and non-binary workers targeted due to their gender identity and to identify correlates of this workplace violence.</p><p><strong>Methods: </strong>This descriptive cross-sectional study used data from 4597 transgender or non-binary respondents from the 2008-2009 National Transgender Discrimination Survey. Respondents reported if they had ever experienced harassment, physical violence or sexual assault at work specifically because of their gender identity. We estimated the prevalence of each type of violence stratified by gender identity, race/ethnicity, age, educational attainment, history of working in the street economy (eg, sex industry, drug sales) and if people at work knew their gender identity.</p><p><strong>Results: </strong>Workplace violence was prevalent, with 50% of transgender and non-binary workers having ever experienced harassment, 7% physical violence and 6% sexual assault at work because of their gender identity. Harassment was common among all of these workers, but physical violence and sexual assault were more than twice as common among transfeminine and non-binary workers assigned male at birth, workers of colour, workers with low educational attainment and those who had ever worked in the street economy.</p><p><strong>Conclusions: </strong>Transgender and non-binary workers commonly face violence at work because of their gender identity. Workplace violence prevention programmes should incorporate ways to prevent gender identity-based violence and facilitate channels for workers to report the occurrence of discrimination and violence.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"178-183"},"PeriodicalIF":4.9,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in occupational exposure risk for COVID-19 workers' compensation claims across pandemic waves in Ontario.","authors":"Peter M Smith, Qing Liao, Faraz Shahidi, Aviroop Biswas, Lynda S Robson, Victoria Landsman, Cameron Mustard","doi":"10.1136/oemed-2023-109243","DOIUrl":"10.1136/oemed-2023-109243","url":null,"abstract":"<p><strong>Objectives: </strong>To understand rates of work-related COVID-19 (WR-C19) infection by occupational exposures across waves of the COVID-19 pandemic in Ontario, Canada.</p><p><strong>Methods: </strong>We combined workers' compensation claims for COVID-19 with data from Statistics Canada's Labour Force Survey, to estimate rates of WR-C19 among workers spending the majority of their working time at the workplace between 1 April 2020 and 30 April 2022. Occupational exposures, imputed using a job exposure matrix, were whether the occupation was public facing, proximity to others at work, location of work and a summary measure of low, medium and high occupational exposure. Negative binomial regression models examined the relationship between occupational exposures and risk of WR-C19, adjusting for covariates.</p><p><strong>Results: </strong>Trends in rates of WR-C19 differed from overall COVID-19 cases among the working-aged population. All occupational exposures were associated with increased risk of WR-C19, with risk ratios for medium and high summary exposures being 1.30 (95% CI 1.09 to 1.55) and 2.46 (95% CI 2.10 to 2.88), respectively, in fully adjusted models. The magnitude of associations between occupational exposures and risk of WR-C19 differed across waves of the pandemic, being weakest for most exposures in period March 2021 to June 2021, and highest at the start of the pandemic and during the Omicron wave (December 2021 to April 2022).</p><p><strong>Conclusions: </strong>Occupational exposures were consistently associated with increased risk of WR-C19, although the magnitude of this relationship differed across pandemic waves in Ontario. Preparation for future pandemics should consider more accurate reporting of WR-C19 infections and the potential dynamic nature of occupational exposures.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"171-177"},"PeriodicalIF":4.9,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for SARS-CoV-2 infection at a UK electricity-generating company: a test-negative design case-control study.","authors":"Charlotte E Rutter, Martie van Tongeren, Tony Fletcher, Sarah Rhodes, Yiqun Chen, Ian Hall, Nicholas Warren, Neil Pearce","doi":"10.1136/oemed-2023-109184","DOIUrl":"10.1136/oemed-2023-109184","url":null,"abstract":"<p><strong>Objectives: </strong>Identify workplace risk factors for SARS-CoV-2 infection, using data collected by a UK electricity-generating company.</p><p><strong>Methods: </strong>Using a test-negative design case-control study, we estimated the OR of infection by job category, site, test reason, sex, vaccination status, vulnerability, site outage and site COVID-19 weekly risk rating, adjusting for age, test date and test type.</p><p><strong>Results: </strong>From an original 80 077 COVID-19 tests, there were 70 646 included in the final analysis. Most exclusions were due to being visitor tests (5030) or tests after an individual first tested positive (2968).Women were less likely to test positive than men (OR=0.71; 95% CI 0.58 to 0.86). Test reason was strongly associated with positivity and although not a cause of infection itself, due to differing test regimes by area, it was a strong confounder for other variables. Compared with routine tests, tests due to symptoms were highest risk (94.99; 78.29 to 115.24), followed by close contact (16.73; 13.80 to 20.29) and broader-defined work contact 2.66 (1.99 to 3.56). After adjustment, we found little difference in risk by job category, but some differences by site with three sites showing substantially lower risks, and one site showing higher risks in the final model.</p><p><strong>Conclusions: </strong>In general, infection risk was not associated with job category. Vulnerable individuals were at slightly lower risk, tests during outages were higher risk, vaccination showed no evidence of an effect on testing positive, and site COVID-19 risk rating did not show an ordered trend in positivity rates.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"184-190"},"PeriodicalIF":4.9,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in work schedule affect headache frequency among Norwegian nurses: a 3-year-follow-up study.","authors":"Espen Saxhaug Kristoffersen, Siri Waage, Staale Pallesen, Bjørn Bjorvatn","doi":"10.1136/oemed-2023-109164","DOIUrl":"10.1136/oemed-2023-109164","url":null,"abstract":"<p><strong>Objectives: </strong>To explore whether changes in work schedule, number of night shifts and number of quick returns were related to changes in headache frequencies.</p><p><strong>Methods: </strong>A longitudinal study with questionnaire data from 2014 (baseline) and 2017 (follow-up) on work schedule (day only, shift work without nights and shift work with nights), number of night shifts, number of quick returns (less than 11 hours in-between shifts) and validated headache diagnoses among 1104 Norwegian nurses. Associations were explored by adjusted multivariate regression analyses.</p><p><strong>Results: </strong>The median age at baseline was 37 years (IQR 31-43) and 90.5% were women. In the adjusted logistic regression analysis of changed work schedule between baseline and follow-up, changing from night work was associated with increased odds for reversion from headache >1 days/month to no headache at all last year (OR 2.77 (1.29; 5.95)). Changes towards less night shifts (>10) or quick returns (>10) during the last year were associated with increased odds of reversion of headache to no headache (OR 2.23 (1.20; 4.17) and OR 1.90 (1.04; 3.49)). Only decrease in number of night shifts (>10) during the last year reduced risk of onset of any new headache between baseline and follow-up (OR of 0.39 (0.18; 0.84)).</p><p><strong>Conclusion: </strong>Changing from night work and reducing the number of night shifts and quick returns were associated with less headache in this 3-year-follow-up of Norwegian nurses. This adds to the growing body of evidence that night work may have direct negative health consequences.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"191-200"},"PeriodicalIF":4.9,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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","authors":"Ireny Y K Iskandar, David J Gawkrodger, Laura Byrne, Matthew Gittins, Melanie Carder, David Fishwick, Martie van Tongeren","doi":"10.1136/oemed-2023-109066","DOIUrl":"https://doi.org/10.1136/oemed-2023-109066","url":null,"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. Data are available upon reasonable request.","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":"117 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140624042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}