SWORD '96: surveillance of work-related and occupational respiratory disease in the UK.

Chest and occupational physicians who report to the SWORD surveillance scheme are estimated to have seen some 3,300 new cases of work-related respiratory disease in 1996. This total has regained the level recorded prior to a low in 1995, probably because of improved chest physician participation and the introduction of a sampling system for occupational physicians. Trends in disease incidence have remained fairly constant with some changes only in pneumoconiosis and inhalation accidents. It is of concern that there has been no evidence of a decrease in frequency of occupational asthma or in any of the incriminated agents since the scheme began in 1989. Comparison with other sources of data shows that, for asthma, SWORD records a relatively high frequency in women, a substantial proportion of whom do not appear to receive compensation. For mesothelioma, rates based on death certificates continue for understandable reasons to run at about twice the level reported to SWORD or as reflected by successful claims to the DSS for industrial injuries benefit. The SWORD programme is now one of six clinically-based reporting schemes which, by the end of 1997, are planned to cover all types of occupational disease in the UK.