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Eur Respir J. 2017 Dec 28;50(6). pii: 1700961. doi: 10.1183/13993003.00961-2017. Print 2017 Dec.

Chest physician-reported, work-related, long-latency respiratory disease in Great Britain.

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Centre for Occupational and Environmental Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
Statistics and Epidemiology Unit, Health and Safety Executive, Bootle, UK.
Biostatistics, The University of Manchester, Manchester, UK.
NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester, UK.
Dept of Respiratory Medicine, Raigmore Hospital, Inverness, UK.
Centre for Workplace Health, Health and Safety Executive, Buxton, UK.
Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK.


Much of the current burden of long-latency respiratory disease (LLRD) in Great Britain is attributed to historical asbestos exposure. However, continuing exposure to other agents, notably silica, also contributes to disease burden. The aim of this study was to investigate the incidence of work-related LLRD reported by chest physicians in Great Britain, including variations by age, gender, occupation and suspected agent.LLRD incidence and incidence rate ratios by occupation were estimated (1996-2014). Mesothelioma cases by occupation were compared with proportional mortality ratios.Cases were predominantly in men (95%) and 92% of all cases were attributed to asbestos. Annual average incidence rates (males) per 100 000 were: benign pleural disease, 7.1 (95% CI 6.0-8.2); mesothelioma, 5.4 (4.8-6.0); pneumoconiosis, 1.9 (1.7-2.2); lung cancer, 0.8 (0.6-1.0); chronic obstructive pulmonary disease (COPD), 0.3 (0.2-0.4). Occupations with a particularly high incidence of LLRD were miners and quarrymen (COPD), plumbers and gas fitters (asbestosis), and shipyard and dock workers (all other categories). There was a clear concordance between cases of SWORD mesothelioma and proportional mortality ratios by occupation.Occupationally caused LLRD continues to contribute to a significant disease burden. Many cases are attributable to past exposure to agents such as asbestos and silica, but the potential for occupational exposures persists.

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