Trends in occupational respiratory conditions with short latency from 1999 to 2019 in the UK - evidence from the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) reporting scheme

BackgroundOccupational 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. AimsThis study aimed to examine which occupations and industries are currently at high risk for SLRD and determine their respective suspected causal agents based on cases reported by physicians to the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) scheme in the UK. MethodsSLRD cases reported to the SWORD scheme between 1999 and 2019 were analysed to determine directly standardised rate ratios (SRR) by occupation against the average rate for all other occupations combined. ResultsBakers and flour confectioners showed significantly raised SRR for occupational rhinitis (234.4 [95% CI, 200.5 - 274.0]) and asthma (59.9 [95% CI, 51.6 - 69.5]). Chemical and related process operatives also presented raised SRR values for these two conditions, with SRR of 29.5 [95% CI, 24.3 - 35.7] and 21.0 [95% CI, 16.9 - 26.1] for rhinitis and asthma, respectively. SRR were also significantly raised for vehicle spray painters when considering occupational asthma (63.5 [95% CI, 51.5 - 78.3]) alone, and laboratory technicians were also amongst the top three increased SRR for rhinitis (18.7 [95% CI, 15.1 - 23.1]). The suspected agents most frequently associated with these occupations and conditions were flour, isocyanates, and 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]) and the suspected causal agent predominantly reported for this condition was pathogens and microorganisms, with a predominance of Mycobacterium tuberculosis. ConclusionsThis study identified the occupational groups at increased risk of developing a SLRD based on data recorded over a recent two-decade period in the UK. Asthma and rhinitis were identified as the prevailing conditions and hypersensitivity pneumonitis as a potentially rising respiratory problem in the metalworking industry.