Occupational Asthma Reference

Bakerly ND, Moore VC, Vellore AD, Jaakkola MS, Robertson AS, Burge PS, Fifteen-year trends in occupational asthma: data from the Shield surveillance scheme, Occup Med (London), 2008;58:169-174,

Keywords: Shield, UK, Glutaraldehyde, Cobalt, isocyanate, metal working fluid, latex, welder

Known Authors

Sherwood Burge, Oasys Sherwood Burge

Vicky Moore, Oasys Vicky Moore

Alastair Robertson, Selly Oak Hospital Alastair Robertson

Arun Dev Vellore, Oasys Arun Dev Vellore

Maritta Jaakkola, Oulu University Finland Maritta Jaakkola

Nawar Bakerly, Birmingham Heartlands Hospital Nawar Bakerly

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Abstract

Background
Trends of occupational asthma (OA) differ between regions depending on local industries, provisions for health and safety at the workplace and the availability of a reporting scheme to help in data collection and interpretation.

Aim
To assess trends in OA in an industrialized part of the UK over a 15-year period.

Methods Occupational and chest physicians in the West Midlands were invited to submit details of newly diagnosed cases with OA. Data were then transferred to the regional centre for occupational lung diseases for analysis.

Results
A total of 1461 cases were reported to the scheme. Sixty-eight per cent were males with mean (standard deviation) age of 44 (12) years. The annual incidence of OA was 42 per million of working population (95% CI 5 37–45). OA was most frequently reported in welders (9%) and health carerelated
professions (9%) while ,1% of cases were reported in farmers. Isocyanates were the commonest offending agents responsible for 21% of reports followed by metal working fluids (MWFs) (11%), adhesives (7%), chrome (7%), latex (6%) and glutaraldehyde (6%). Flour was suspected in 5% of cases while laboratory animals only in 1%.

Conclusions
Our data confirm a high annual incidence of OA in this part of the UK. MWFs are an emerging problem, while isocyanates remain the commonest cause. Incidence remained at a fairly stable background level with many small and a few large epidemics superimposed. Schemes like Midland Thoracic Society’s Rare Respiratory Disease Registry Surveillance Scheme of Occupational Asthma
could help in identifying outbreaks by linking cases at the workplace.

Plain text: Background Trends of occupational asthma (OA) differ between regions depending on local industries, provisions for health and safety at the workplace and the availability of a reporting scheme to help in data collection and interpretation. Aim To assess trends in OA in an industrialized part of the UK over a 15-year period. Methods Occupational and chest physicians in the West Midlands were invited to submit details of newly diagnosed cases with OA. Data were then transferred to the regional centre for occupational lung diseases for analysis. Results A total of 1461 cases were reported to the scheme. Sixty-eight per cent were males with mean (standard deviation) age of 44 (12) years. The annual incidence of OA was 42 per million of working population (95% CI 5 37-45). OA was most frequently reported in welders (9%) and health carerelated professions (9%) while ,1% of cases were reported in farmers. Isocyanates were the commonest offending agents responsible for 21% of reports followed by metal working fluids (MWFs) (11%), adhesives (7%), chrome (7%), latex (6%) and glutaraldehyde (6%). Flour was suspected in 5% of cases while laboratory animals only in 1%. Conclusions Our data confirm a high annual incidence of OA in this part of the UK. MWFs are an emerging problem, while isocyanates remain the commonest cause. Incidence remained at a fairly stable background level with many small and a few large epidemics superimposed. Schemes like Midland Thoracic Society's Rare Respiratory Disease Registry Surveillance Scheme of Occupational Asthma could help in identifying outbreaks by linking cases at the workplace.

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