Assessing the impact of national level interventions on workplace respiratory disease in the UK: part 1—changes in workplace exposure legislation and market forces

Abstract

These data are consistent with a beneficial effect of legislation aiming to reduce workplace exposures.

Worldwide trends in incidence in occupational allergy and asthma

“…This is consistent with the German Information Network of Departments of Dermatology reporting a significantly increasing trend in positive patch tests for OACD caused by isothiazolinones [38] and the UK THOR database reporting a significantly increasing trend for OACD attributed to acrylates in beauticians [37,39]. Both RNV3P and THOR reported no significant trend in the incidence of OACD attributed to rubber additives [18,40] and significantly decreasing trends for OCU attributed to latex [19 & ,40].…”

“…It is likely that these reflect similar exposures as quaternary ammonium products were analyzed separately from cleaning products in RNV3P but not in SHIELD. The UK THOR database reported a declining trend in occupational asthma attributed to latex and glutaraldehyde in healthcare workers [37] and isocyanates in all workers [4 & ] in agreement with RNV3P and SHIELD (however, some of the cases reported to SHIELD may also be reported to THOR).…”

“…Once a reliable method to estimate national-level trends in OAA is established, it is relatively straightforward to apply the method to examining the impact of national-level interventions on the incidence of OAA [44] or explain trends in terms of changes in market forces or legislation [37]. As long as potential confounding is considered appropriately, temporal changes in incidence can provide circumstantial evidence of the impact of an intervention, but if simultaneous trends in exposure are also known there is stronger evidence for a causal relationship.…”

Twenty years of SHIELD: decreasing incidence of occupational asthma in the West Midlands, UK?

“…Blood-borne infections and hospital cross infection in the National Health Service in the 1990s led to an increase in the use of powdered latex examination gloves, and although there is no evidence that supports the observed step increase in cases in 1995, we suggest that this reflects a cultural change in awareness of the disease among healthcare professionals around that time. The decrease in latex-related notifications after 1995 reflects the subsequent replacement with nitrile and vinyl gloves33 and mirrors the trends in short-latency respiratory disease due to latex seen in the SWORD surveillance scheme 34…”

Trends in incidence of occupational asthma

“…These findings may be a reason for cautious optimism as to possible benefit from preventive measures for OA (as previously suggested with exposure control regulations in the UK 6 7…”