Trends in occupational respiratory conditions with short latency in the UK

Abstract

Background: Occupational short-latency respiratory disease (SLRD; predominantly asthma, rhinitis, hypersensitivity pneumonitis, and occupational infections) prevalence is difficult to determine but certain occupations may be associated with increased susceptibility.

Aims: This study aimed to examine which occupations and industries are currently at high risk for SLRD and determine their respective suspected causal agents.

Methods: SLRD cases reported to the SWORD scheme between 1999 and 2019 were analysed to determine directly standardized rate ratios (SRR) by occupation against the average rate for all other occupations combined.

Results: 'Bakers and flour confectioners' and 'vehicle spray painters' showed significantly raised SRR for SLRD in general, mostly due to occupational rhinitis (234.4; 95% CI 200.5-274.0) and asthma (63.5; 95% CI 51.5-78.3), respectively. Laboratory technicians also showed significantly raised SRR for occupational rhinitis (18.7; 95% CI 15.1-23.1), primarily caused by laboratory animals and insects. Metal machining setters and setter-operators showed increased SRR for occupational hypersensitivity pneumonitis (42.0; 95% CI 29.3-60.3), largely due to cutting/soluble oils. The occupation mostly affected by infectious disease was welding trades (12.9; 95% CI 5.7-29.3), mainly attributable to microbial pathogenicity.

Conclusions: This study identified the occupational groups at increased risk of developing an SLRD based on data recorded over a recent two-decade period in the UK. Occupational asthma and rhinitis were identified as the prevailing conditions and hypersensitivity pneumonitis as a potentially rising respiratory problem in the metalworking industry.

Figure 1.

Standardized rate ratios (SRR) and 95% CI of medically reported occupational SLRD incidence reported to SWORD compared with all other employment sectors combined (1999–2019). Please note the x-axis log scale.

Figure 2.

Suspected causal agents associated with the different occupational short-latency respiratory disease (SLRD) categories reported to SWORD (1999–2019). Vertical bars represent the percentage of each agent relative to the total frequency of the top ten agents reported (n), as indicated by the grey concentric lines. The suspected agents’ subcategories are not necessarily grouped or ranked according to the hierarchy of the coding system.

Figure 3.

Suspected causal agents of occupational SLRD reported to SWORD (1999–2019). The suspected agents are organized according to the SWORD coding system categories and provide a higher-level classification in terms of their chemical, molecular and structural properties (e.g. flour and enzymes are categorized as ‘Biological substances’).