Methods A nationwide database was constructed by linking Swedish Census data to the Hospital Discharge Register (1987–2004). The hospital diagnoses of asthma were based on the International Classification of Diseases. Standardized incidence ratios were calculated for different socioeconomic and occupational groups. Ninety-five per cent confidence intervals were calculated assuming a Poisson distribution.

Results A total of 13 202 male and 11 876 female hospitalizations for asthma were retrieved at ages >30 years. The socioeconomic groups with <9 years of education were associated with a significantly increased risk of hospitalization for asthma. Among male occupations, increased risks were noted for farmers, mechanics and iron and metal workers, welders, bricklayers, workers in food manufacture, packers, loaders and warehouse workers, waiters and chimney sweeps with prolonged exposures in two censuses. For female occupations, increased risks were observed among assistant nurses, religious, juridical and other social science-related workers, drivers, mechanics and iron and metalware workers and wood workers.

Conclusions The present study suggests that socioeconomic status (low educational level) and occupation have an effect on the population's risk of hospitalization for asthma.

Aim To assess trends in OA in an industrialized part of the UK over a 15-year period.

Methods Occupational and chest physicians in the West Midlands were invited to submit details of newly diagnosed cases with OA. Data were then transferred to the regional centre for occupational lung diseases for analysis.

Results A total of 1461 cases were reported to the scheme. Sixty-eight per cent were males with mean (standard deviation) age of 44 (12) years. The annual incidence of OA was 42 per million of working population (95% CI = 37–45). OA was most frequently reported in welders (9%) and health care-related professions (9%) while <1% of cases were reported in farmers. Isocyanates were the commonest offending agents responsible for 21% of reports followed by metal working fluids (MWFs) (11%), adhesives (7%), chrome (7%), latex (6%) and glutaraldehyde (6%). Flour was suspected in 5% of cases while laboratory animals only in 1%.

Conclusions Our data confirm a high annual incidence of OA in this part of the UK. MWFs are an emerging problem, while isocyanates remain the commonest cause. Incidence remained at a fairly stable background level with many small and a few large epidemics superimposed. Schemes like Midland Thoracic Society's Rare Respiratory Disease Registry Surveillance Scheme of Occupational Asthma could help in identifying outbreaks by linking cases at the workplace.

Aims To investigate whether lung cancer screening with CT was effective and acceptable in former asbestos workers.

Methods CT scanning was carried out following the protocol previously described in the literature. A questionnaire was used to assess cumulative asbestos exposure. An economic analysis was also performed. Informed consent was obtained from all patients.

Results A total of 1119 male asbestos workers (58% of invited) were examined, of whom 65% were smokers or ex-smokers. Mean age was 57.1 years with mean cumulative exposure to asbestos of 123 fibres/ml x years. Pleural plaques were found in 375 workers (32%), while 338 workers (29%) were included in the radiological follow-up, which led to 25 biopsies (13 of lung, 9 of pleura, 3 of both) and five screen-detected lung cancers (0.4%), one in Stage I. Incidence rate was 149 per 10⁵, equal to that in the male general population of similar age. The expenses for diagnosis were 1014 and 244962 Euro per screened subject and screen-detected lung cancer case, respectively.

Conclusions Screening adherence and frequency of detection were low, while costs and radiation dose were high. In spite of a high cumulative asbestos exposure, lung cancer risk was not increased relative to the general population. The screening programme was not felt to be cost-effective from the perspective of the government as a third-party funding agency.

Aims To define the specificity and sensitivity of thermometry and plethysmography using the SWS as the reference criterion. A secondary goal was to consider cut points for the tests optimizing sensitivity and specificity.

Methods A cross-sectional analysis was conducted on HAVS patients seen at an occupational medicine specialty clinic. Plethysmography and thermometry were analyzed using SWS vascular stage as the outcome variable. Logistic regression controlled for age, smoking and time since last vibration exposure and use of vasoactive medications. The sensitivity and specificity of the combined tests were calculated using varying cut points.

Results A total of 139 patients consented to participate in the study. Plethysmography stage 1 or greater showed the highest sensitivity (sensitivity 94% and specificity 15%). Specificity was optimized combining plethysmography stage 3 and thermometry stage 3 (specificity 98% and sensitivity 23%). Maximal diagnostic accuracy was achieved by plethysmography alone setting the criteria for a positive test as being stage 1 or greater (70%).

Conclusions Neither plethysmography nor thermometry either alone or in combination demonstrated sufficient sensitivity and specificity to serve as an objective correlate for SWS vascular stage. All combinations of plethysmography and thermometry showed a lower specificity than sensitivity indicating that the SWS may be less sensitive in detecting vascular pathology than the objective tests.

Aim To determine relevant factors related to return to work.

Methods Surgical technique, clinical factors, demographic factors, other medical problems, psychosocial factors, work-related and economical factors were reviewed in patients operated on for CTS. Statistical multivariate analyses were performed to identify the baseline factors influencing the work incapacity period.

Results A total of 107 cases were reviewed. Professional exposure to repetitive movements and heavy manual handling activity were associated with a longer return-to-work interval. The duration of work incapacity period was not significantly related to the socioprofessional category of the patient (self-employed or employee) or to the type of the procedure (open versus endoscopic surgery).

Conclusion Work-related features have a more important influence on return to work than personal, pathological or surgical features.

Aims To identify differences in the mental health status and social attitudes towards PG among casino workers in South Korea depending upon whether they report any gambling problems.

Methods Data were collected from 388 full-time casino employees. This data provided information about the prevalence of gambling problems, alcohol and tobacco use and depression. Employees were grouped according to their scores on the Korean version of South Oaks Gambling Screen (SOGS), and those employees who gambled without experiencing any gambling problems (Group NP: SOGS = 0) and those who reported any gambling problems (Group P: SOGS > 0) were compared. An exploratory factor analyses identified the domains of casino employee social attitudes towards gambling.

Results Employees who reported gambling problems (Group P) reported a higher prevalence of smoking, alcohol problems and depression (P < 0.01) compared to employees who did not report gambling problems (Group NP). The primary employee social attitude towards gambling was identified by the factor of ‘Disease concept/social awareness’. Group NP reported more positive attitudes in this domain than Group P (P < 0.01).

Conclusions Employees who reported any gambling problems reported a less positive attitude towards developing the public health system to be responsive to gambling problems. These findings indicate a need to develop health education programmes that focus more specifically on casino employees with gambling problems.

Aims To examine the prevalence of fatigue among seafarers, identify potential risk factors and assess possible links with poor performance and ill-health.

Methods Cross-sectional questionnaire survey of seafarers working in the offshore oil support, short-sea and deep-sea shipping industries. A number of tools were used including the fatigue subscale of the profile of fatigue-related symptoms, the Cognitive Failures Questionnaire, the General Health Questionnaire and the SF36 General Health scale.

Results In all, 1855 questionnaires were completed giving an overall response rate of 20%. Fatigue symptoms were associated with a range of occupational and environmental factors, many unique to seafaring. Reporting a greater number of risk factors was associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35) for those with three or four risk factors and OR = 9.54 (6.95–13.09) for those with five or more risk factors]. There was also a strong link between fatigue and poorer cognitive and health outcomes, with fatigue the most important of a number of risk factors, accounting for 10–14% of the variance.

Conclusions Seafarers' fatigue could impact on safety within the industry and may be linked to longer term individual ill-health. It can only be addressed by considering how multiple factors combine to contribute to fatigue.

Methods A systematic review was undertaken. Abstracts were screened and those selected reviewed against pre-determined diagnostic criteria for RADS.

Results Significant information gaps were identified for all measures of interest. In some articles, even the causative agent was not reported. The most commonly reported agents were chlorine (nine subjects), toluene di-isocyanate (TDI) (n = 6) and oxides of nitrogen (n = 5). Most exposures occurred in the workplace (n = 51) and affected men (60%). Dyspnoea (71%) and cough (65%) were the commonest symptoms. Median symptom duration was 13 months (interquartile range = 6.5–43.5) for RADS.

Conclusions Although the most commonly reported agent associated with RADS was chlorine, the main finding of a general lack of adequate information on exposure, investigation and outcome suggests that to better explore RADS a more structured approach to gathering information is required. A minimum data set for reporting RADS cases is proposed.

Methods Subjects were recruited from a factory of 650 workers and assessed by means of history, physical examination and electrophysiological testing.

Results Seventy-nine subjects from the factory and 53 healthy controls with occupations unrelated to heavy physical work were assessed. None of the worker group had electrophysiological evidence of CTS. One subject in the control group has electrophysiological evidence of CTS. In the worker group, all sensory nerve conduction velocities and ulnar nerve action potential amplitudes in both hands and distal motor latencies were statistically different.

Conclusions In our study, among a group of heavy labourers, no cases of CTS were detected. However, all electrophysiologic parameters of workers were different from controls. Our results point to a diffuse, but subclinical injury of peripheral nerves under heavy physical work conditions, instead of a local effect such as CTS.

Methods All subjects employed at an autocatalyst production plant undertook medical surveillance with symptoms, examination findings and results of skin prick testing and spirometry prospectively recorded. Environmental testing of the workplace was also performed to determine the level of exposure.

Results Twenty-six subjects had a mean duration of employment of 46 (±30) months and undertook a mean 6.8 (±4.3) examinations. No subjects described the development of new respiratory or dermatological symptoms. No patients developed positive skin reactivity to platinum salts. FEV₁ remained unchanged for all subjects over the course of the study period.

Conclusions TPC and platinum-group elements are not associated with the development of PSS or occupational asthma. Identification of chemical compounds is important when advising on occupational health screening. TPC and/or platinum-group elements should be used in preference to chloroplatinic acid in catalyst production to minimize the impact of occupational illness due to PSS.