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.
Eur Respir J. 2017 Dec 28;50(6). doi: 10.1183/13993003.00961-2017. Print 2017 Dec.
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.
目前英国长期潜伏性呼吸系统疾病（LLRD）的主要负担归因于历史上的石棉暴露。然而，继续接触其他物质，特别是二氧化硅，也会导致疾病负担。本研究旨在调查英国胸部医生报告的与工作相关的 LLRD 的发病率，包括按年龄、性别、职业和可疑因素的变化。通过职业估计了 LLRD 的发病率和发病率比（1996-2014 年）。将职业性间皮瘤病例与比例死亡率进行了比较。病例主要为男性（95%），所有病例中有 92%归因于石棉。每年每 100000 名男性的平均发病率（男性）为：良性胸膜疾病，7.1（95%CI 6.0-8.2）；间皮瘤，5.4（4.8-6.0）；尘肺，1.9（1.7-2.2）；肺癌，0.8（0.6-1.0）；慢性阻塞性肺疾病（COPD），0.3（0.2-0.4）。与 LLRD 发病率特别高的职业包括矿工和采石工（COPD）、水管工和煤气装配工（石棉肺）以及造船厂和码头工人（所有其他类别）。SWORD 间皮瘤病例与职业比例死亡率之间存在明显的一致性。职业性引起的 LLRD 仍对重大疾病负担做出贡献。许多病例归因于过去接触石棉和二氧化硅等物质，但职业接触的潜在风险仍然存在。
