Work-related respiratory disease in the United Kingdom, 1989-1992: report on the SWORD project.

The objective of this project is the creation of a reliable and cost-effective national system of surveillance for work-related respiratory disease as a basis for control and simple epidemiological research. With the voluntary participation of almost 800 chest and occupational physicians from throughout the UK, newly diagnosed cases of respiratory illness thought to be due to occupational factors have been reported regularly since January 1989. Since January 1992, reports from chest physicians have been submitted monthly by a core group with special interest in occupational lung disease (n = 32) and rotating random samples of the remainder. Between 1989 and 1991, 5576 new cases were reported, of which half were diseases of long latency mainly due to asbestos, 28% were occupational asthma, and the rest were divided between inhalation accidents (10%) and a variety of other acute diseases (14%). Disease incidence rates, with denominators from the Labour Force Survey, showed a very high risk of asthma among paint sprayers, chemical and food processors, laboratory staff, plastics and metal treatment workers, and in welding and electronic assembly. Some of the same groups also experienced high rates of inhalation accidents and bronchitis. The risk of diseases of long latency, using denominators from the 1961 census, was highest in shipyard and dock workers, miners and construction workers. The SWORD scheme has provided estimates of disease incidence not previously available, has encouraged awareness of occupational factors among chest physicians, has assisted those responsible for prevention and control, and has demonstrated the feasibility of this approach to surveillance.