Introduction Patients with suspected work-related respiratory symptoms are referred to tertiary NHS clinics in the UK for diagnosis of an occupational lung disease. Analysis of diagnosis data provides an opportunity to understand the profile of occupations and workplace exposures.
Methods The study population comprised 500 patients who were referred to a tertiary occupational respiratory unit (Heart of England NHS Foundation Trust, UK) and diagnosed with an occupational respiratory disease. The 500 cases were randomly selected from a database of 2400 patients diagnosed over the period 2010–2015. Information on patients included: occupation (current), industry type, gender, diagnosis and date of diagnosis. The occupation titles were first reviewed and then coded (using CASCOT) at the four-digit level using SOC 2000. The automated assigned codes were accepted where percentage match was ≥50%, the remainder of jobs coded manually using information on industry type. A UK general population JEM (ACEJEM) was then linked to the assigned SOC codes. The job coding was conducted independently of knowledge of diagnosed lung diseases.
Results Job titles and diagnosis were available for 497 patients. 73% of the job titles were coded automatically. The most common diagnosis was asthma 141 (28%), pleural plaques 119 (24%) and pneumoconiosis 81 (16%). 402 (81%) of the patient jobs were allocated to three of nine main SOC occupational groups; ‘skilled trade occupation’, ‘process, and machine operators’ and ‘elementary occupations’. Over 89% of asthma and pneumoconiosis cases were exposed to vapours, gases, dust or fumes (VGDF). Of the asthma cases the highest proportion were exposed to dusts (81%, 114/141) and mineral dusts (66%, 93/141), and assigned as exposed to moderate or high level of dust exposure. Only 29% of the asbestosis cases were assigned as exposed to fibres. The most common 4 digit code for asthma was 5241 (Electricians and electrical fitters), followed by 5315 (carpenters and joiners).
Conclusion The use of a general population JEM and coding of patient jobs enables a standardised approach to understanding the nature of occupations and workplace exposures for different lung disease. The approach overcomes the reliance on patient recall of workplace exposures.
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