Working Partnerships: Applying Research to Practice, NORA Symposium 2003, June 23-24, 2003, Arlington, Virginia. Washington, DC: National Institute for Occupational Safety and Health, 2003 Jun; :32
As part of its mission, the Division of Respiratory Disease Studies, NIOSH, disseminates information on the severity and extent of occupational lung diseases and related workplace exposures. Towards this end, the sixth of a series of Work-Related Lung Disease (WoRLD) Surveillance Reports has recently been completed. This report provides current and detailed information on various work-related respiratory diseases and associated exposures in the United States. It describes where these diseases are occurring (by industry and geographic location), who is affected (by race, gender, age, and occupation), how frequently they occur, and temporal trends. The current WoRLD Report includes sections on asthma and chronic obstructive pulmonary disease (COPD), diseases which together comprise a major NORA priority research area. Our presentation highlights key asthma and COPD findings from the 2002 WORLD Report. Methods: We abstracted key findings from the 2002 WoRLD Report, including findings based on: (1) asthma cases ascertained by public health surveillance programs in four states (California, Massachusetts, Michigan, New Jersey) during the period 1993-1999; (2) 2000 National Health Interview Survey (NHIS) data on asthma and COPD; (3) National Center for Health Statistics multiple-cause-of-death data, restricted to U.S. residents aged 15 years and older, for asthma (1990-1999) and for COPD (1999). Findings: Over 2,500 cases of work-related asthma were identified for the period 1993-1999 in the four states. About 80% represented asthma caused by occupational exposure, while 20% represented preexisting asthma aggravated by occupational exposure. Cases were most frequently attributed to the following agents: miscellaneous chemicals, cleaning materials, miscellaneous dusts, indoor air pollutants, pyrolysis products, and isocyanates. The three primary industries with the greatest number of asthma cases were: transportation equipment manufacturing (19%), health services (16%), and educational services (9%). Based on the NHIS data, elementary and secondary schools and colleges was the one current industry sector having a clearly elevated asthma prevalence among nonsmokers. Among the 11 usual industries with significantly elevated proportionate mortality for asthma, five were associated with healthcare, two with education, and two with agricultural industries. Similarly, among the 22 occupations with significantly elevated asthma mortality, healthcare-related jobs accounted for nine, and education jobs for four. No clear patterns of COPD morbidity emerged from the NHIS data. However, national cause-of-death data revealed clear excesses of COPD mortality among miners, construction workers, transportation workers, and food service workers, among others. The mortality findings confirm, in part, results reported elsewhere, although the contribution of smoking to the excesses has not been evaluated here. Overall, the findings provide information useful for identifying where work-related asthma and COPD may be occurring and for guiding targeted prevention programs.
Working Partnerships: Applying Research to Practice, NORA Symposium 2003, June 23-24, 2003, Arlington, Virginia