! I" * \4 Occupational Health Decennial Supplement Edited by Frances Drever - •» Office of Population Censuses and Surveys Health and Safety Executive Series DS no. 10 Occupational Health Decennial Supplement The Registrar General’s decennial supplement for England and Wales Edited by Frances Drever I. I incksH-r oJL xL omA. uj aJj^> CXA" ^ SocacJI j-KdU ooJFoG - vv iVLLCO LIBRARY ;neral Collections M London: HMSO / © Crown copyright 1995 First published 1995 ISBN 0 11 691618 4 I Printed in the United Kingdom for HMSO Dd300387 3/95 C18 G3397 10170 Foreword For over 150 years, data on occupational mortality have been made available in the Registrar Generals’ Decennial Supplements. The present volume - Occupational Health - is a joint venture of the Office of Population Censuses and Surveys and the Health and Safety Executive. Not only is occupational mortality commented on, but health related issues are discussed. There are chapters on injuries at work, asbestos-related diseases, sickness absence and smoking and drinking. Authors outside government have been involved in writing several chapters, noticeably on mortality and cancer registration. This is the first in a new series of decennial supplements. The Health of Adult Britain and The Health of Our Children - a review’ in the 1990s will be available later in 1995. OPCS is planning a volume on socio-economic differences in health for publication in late 1997. This book is only possible because of the hard work of many people. The authors of individual chapters are to be commended in managing to co-operate with each other. Mr Tim Devis and Dr Morris Greenberg did much of the preliminary work including ensuring authors had the data they required. Mrs Frances Drever joined the team late in the day but edited the volume and saw the volume through the production process. Ms Karen Dunnell and Dr John Osman oversaw the project from beginning to / end. Without these and all the people in the background this volume would never have been produced. Dr John Fox CHIEF MEDICAL STATISTICIAN OPCS Main contributors Mrs Frances Drever Mr Philip McCrea Ms Ann Bethune Health and Safety Executive Dr Penny Babb Baynards House Dr Morris Greenberg 1 Chepstow Place OPCS Westboume Grove St Catherine’s House London 10 Kings way W2 4TF London WC2B 6JP Dr David Coggon Ms Heather Inskip Dr John Osman Mr Paul Winter Dr Richard Elliott MRC Ms Jacky Jones Environmental Epidemiology Unit Health and Safety Executive University of Southampton Magdalen House Southampton General Hospital Stanley Precinct Southampton Bootle S016 6YD Merseyside L20 3QZ Dr Eve Roman Dr Lucy Carpenter Ms Jacqui Cooper Imperial Cancer Research Fund Health and Safety Executive Cancer Epidemiology Unit Daniel House Gibson Building Trinity Road The Radcliffe Infirmary Bootle Oxford Merseyside 0X2 6HE L20 7HE IV Contents Page Foreword iii Main contributors iv List of tables ix List of figures xiv Summary xvii 1 The background to the decennial supplements John Osman 1.1 Introduction 1 1.2 History of the decennial supplements 1 1.3 Broadening the scope of the decennial supplements 2 1.4 Authorship and sponsorship of this volume 4 1.5 Presentation of the data 4 2 Sources and methods Barbara Noble, Frances Drever, Nita Shah 2.1 Introduction 5 2.2 Sources of data 5 2.3 Classification systems 9 2.4 Statistical methods 11 3 Demographic and employment trends Stewart Taylor, Neil Davies, Philip McCrea 3.1 Demographic changes 16 3.2 Patterns of employment 17 3.3 Prospects to the year 2000 19 3.4 Implications for health and safety 21 4 Occupational mortality of men David Coggon, Hazel Inskip, Paul Winter, Brian Pannett 4.1 Introduction 23 4.2 Overall burden of occupational disease 23 4.3 Metal workers 23 4.4 Coal miners 24 4.5 Urothelial cancer in rubber workers 27 4.6 Mortality in farmers 27 4.7 Lung cancer in butchers 30 4.8 Summary for each job group 30 Annex 4.1 Counties making up MAFF regions 43 5 Occupational mortality of women Hazel Inskip, David Coggon, Paul Winter, Brian Pannett 5.1 Introduction 44 5.2 Teachers 45 5.3 Health-related professions 45 5.4 Farmers 46 5.5 Textiles workers 47 5.6 Entertainment and catering 47 5.7 Other raised PMRs of note 48 5.8 Mortality of women by husband’s occupation 49 5.9 Conclusion 51 5.10 Summaries of results for each occupational group 52 v Page 6 Occupational mortality by cause of death David Coggon, Hazel Inskip, Paul Winter, Brian Pannett 6.1 Introduction 62 6.2 Cancers 62 6.3 Diabetes 65 6.4 Viral hepatitis and immunodeficiency 65 6.5 Tuberculosis 67 6.6 Drug dependence 67 6.7 Parkinson’s disease, motor neurone disease, and multiple sclerosis 67 6.8 Epilepsy 68 6.9 Diseases of the circulatory system 68 6.10 Respiratory and related problems 69 6.11 Alcohol related diseases 71 6.12 Gastric ulcer, duodenal ulcer 71 6.13 Injury and poisoning 72 7 Cancer incidence in England, 1981-87 Eve Roman, Lucy Carpenter 7.1 Introduction 77 7.2 Overview of the data 77 7.3 Issues for the interpretation of the results 78 7.4 Results by job group 79 7.5 Result by cancer site: cancers with known occupational associations 79 7.6 Results by cancer site: cancers with suspected occupational associations 81 7.7 Comment 84 7.8 Results by occupational group: commentary 84 8 Mortality of longitudinal study 1971 and 1981 census cohorts Ann Bethune, Seeromanie Harding, Anne Scott, Haroulla Filakti 8.1 Introduction 103 8.2 Method of analysis 103 8.3 Occupational data 103 8.4 Mortality data 104 8.5 Long term follow-up from the 1971 census 105 8.6 Follow-up from 1981 census 113 8.7 Discussion 116 8.8 Conclusion 117 9 Asbestos related diseases Sally Hutchings, Jacky Jones, John Hodgson 9.1 Introduction 127 9.2 Mesothelioma register 127 9.3 Site of cancer 132 9.4 Occupation 134 9.5 Background to the asbestos survey 137 9.6 Results of the mortality analysis 139 9.7 Analysis by industrial sector 144 9.8 Analysis by date of first exposure, latency and age 144 9.9 Effect of smoking 146 Annex 9.1 Background to the Asbestos Survey - legislative framework 147 Annex 9.2 List of jobs for each industrial sector 148 10 Monitoring occupational diseases John Osman, John Hodgson, Sally Hutchings, Jacky Jones, Trevor Benn, Richard Elliott 10.1 Introduction 153 10.2 Labour force survey 153 10.3 Other sources of information and description of main tables 159 10.4 Detailed commentary on specific diseases 168 10.5 Conclusions 184 vi Page 11 Occupational injuries at work Jacqui Cooper 11.1 Sources and definitions 185 11.2 The overall picture 186 11.3 Agriculture 188 11.4 Energy 189 11.5 Manufacturing 190 11.6 Construction 191 11.7 Service industries 193 Annex 11.1 Definitions of terms used 194 12 Smoking, drinking and occupation Richard Elliott 12.1 Introduction 195 12.2 Sources and general methods 195 12.3 Smoking status- general points 196 12.4 Alcohol consumption-general points 198 12.5 Notes on specific occupations 212 12.6 Conclusion 216 13 Occupation and sickness absence Simon Clarke, Richard Elliott, John Osman 13.1 Introduction 217 13.2 Data sources and methods 217 13.3 General comments 219 13.4 Comments by occupational order 228 13.5 Conclusions 231 14 Occupation and fertility Penny Babb 14.1 Introduction 232 14.2 Vital registration data 232 14.3 Methods 232 14.4 Occupational fertility levels 233 14.5 Mean age of mother at childbirth and proportion of jointly registered births outside marriage 233 14.6 Limitations of the analysis 234 15 Ad hoc occupational mortality studies Morris Greenberg 15.1 Introduction 235 15.2 The development of an OPCS service to external research workers 235 15.3 Reasons for the studies 235 15.4 Facilities offered by OPCS to external researchers 236 15.5 Varieties of study designs and analyses 237 15.6 The importance of OPCS assisted studies 238 15.7 The future 239 Annex 15.1 A classification of ad hoc studies assisted by OPCS 239 Annex 15.2 Brief summaries on OPCS studies of occupational health 242 16 International comparisons Morris Greenberg 16.1 Introduction 271 16.2 International standards in occupational health 271 16.3 Problems arising in comparing occupational injury analyses 271 16.4 Some comparisons of fatal occupational accidents 272 16.5 Mortality by occupational group: international comparisons 273 16.6 Occupational diseases 274 16.7 Conclusions 275 Page Appendices 1 Classification of causes of death 279 2 Definition of the Southampton classification of job groups 282 David Coggon, Hazel Inskip, Paul Winter, Brian Pannett 3 Description of job groups of the Southampton classification 292 Brian Pannett, David Coggon, Hazel Inskip, Paul Winter 4 Significant PMRs for each job group 308 Paul Winter, Hazel Inskip, David Coggon, Brian Pannett 5 Cancer incidence in men by job group: cancers with statistically significant PRRs 339 Eve Roman, Lucy Carpenter 6 Cancer incidence in women by job group: cancers with statistically significant PRRs 346 Eve Roman, Lucy Carpenter 7 Mortality of men aged 20 to 64 by cause of deaths and job group, England and Wales, 1979-80,1982-90 (PMR - all men with classifiable occupations 100) 350 = 8 Mortality of women aged 20 to 59 by cause of deaths and job group, England and Wales, 1979-80,1982-90 (PMR - all women with classifiable occupations 100) 362 = Abbreviations 374 viii