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. 1998 Sep;55(9):634–641. doi: 10.1136/oem.55.9.634

Best estimate of the magnitude of mortality due to occupational exposure to hazardous substances

S Morrell, C Kerr, T Driscoll, R Taylor, G Salkeld, S Corbett
PMCID: PMC1757643  PMID: 9861187

Abstract

OBJECTIVES: With a proportionate attributable risk approach, to estimate the magnitude of premature mortality induced by exposure to hazardous substances in the Australian workforce. METHODS: Estimates of the magnitude of mortality induced by exposure to hazardous substances in the Australian work-force were calculated by the proportionate attributable risk approach after careful consideration of options for methodological refinements. The main data sources used were unit mortality datasets (individual deidentified death records), and tabulations when these were unavailable. RESULTS: The estimated number of deaths that occurred in Australia each year from occupational exposure to hazardous substances was 2290; 78% of these were men. The rate of mortality attributable to occupational exposure to hazardous substances was three to four times greater in male workers than in female workers. Male (productive) person-years of life lost (PYLL) were generally eight times higher than female PYLL. Cancer was the prime cause of death, followed by renal, cardiovascular, neurological, and chronic respiratory disease. Acute toxic episodes accounted for a small proportion of mortality but yielded a much larger proportion of PYLL, reflecting the relatively young ages of those who experienced fatal effects. CONCLUSIONS: Although national estimates of the proportions of mortality attributable to occupational exposure to hazardous substances seemed to be validly derived, uncertainties remain associated with the lack of an empirical basis for derivation of proportionate risk fractions used in the calculations. The finding of an appreciable burden of mortality that is attributable to past occupational exposure to hazardous substances emphasises the necessity for occupational health and safety authorities to measure and reduce worksite exposures. There is also an incentive to encourage the construction of appropriately designed cohort studies across industries and occupational groupings so that, ultimately, risk estimates may be directly calculated and applied to total workforce data for the definitive estimation of the magnitude of harm induced by occupational exposure to hazardous substances.

 

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Selected References

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  1. Blanc P. D., Becker C. E. Occupational health planning in Israel: a U.S. perspective. Isr J Med Sci. 1992 Aug-Sep;28(8-9):500–508. [PubMed] [Google Scholar]
  2. Chan-Yeung M., Lam S. Occupational asthma. Am Rev Respir Dis. 1986 Apr;133(4):686–703. doi: 10.1164/arrd.1986.133.4.686. [DOI] [PubMed] [Google Scholar]
  3. Dobson A. J., Kuulasmaa K., Eberle E., Scherer J. Confidence intervals for weighted sums of Poisson parameters. Stat Med. 1991 Mar;10(3):457–462. doi: 10.1002/sim.4780100317. [DOI] [PubMed] [Google Scholar]
  4. Driscoll T. R. Are work-related injuries more common than disease in the workplace? Occup Med (Lond) 1993 Aug;43(3):164–166. doi: 10.1093/occmed/43.3.164. [DOI] [PubMed] [Google Scholar]
  5. Fahs M. C., Markowitz S. B., Fischer E., Shapiro J., Landrigan P. J. Health costs of occupational disease in New York State. Am J Ind Med. 1989;16(4):437–449. doi: 10.1002/ajim.4700160409. [DOI] [PubMed] [Google Scholar]
  6. Feldman J. P., Gerber L. M. Sentinel Health Events (Occupational): analysis of death certificates among residents of Nassau County, NY between 1980-82 for occupationally related causes of death. Am J Public Health. 1990 Feb;80(2):158–161. doi: 10.2105/ajph.80.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Harrison J. E., Frommer M. S., Ruck E. A., Blyth F. M. Deaths as a result of work-related injury in Australia, 1982-1984. Med J Aust. 1989 Feb 6;150(3):118–125. doi: 10.5694/j.1326-5377.1989.tb136388.x. [DOI] [PubMed] [Google Scholar]
  8. Kraut A. Estimates of the extent of morbidity and mortality due to occupational diseases in Canada. Am J Ind Med. 1994 Feb;25(2):267–278. doi: 10.1002/ajim.4700250213. [DOI] [PubMed] [Google Scholar]
  9. Lalich N. R., Schuster L. L. An application of the Sentinel Health Event (Occupational) concept to death certificates. Am J Public Health. 1987 Oct;77(10):1310–1314. doi: 10.2105/ajph.77.10.1310. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Landrigan P. J., Markowitz S. Current magnitude of occupational disease in the United States. Estimates from New York State. Ann N Y Acad Sci. 1989;572:27–60. doi: 10.1111/j.1749-6632.1989.tb13568.x. [DOI] [PubMed] [Google Scholar]
  11. Leigh J. P., Markowitz S. B., Fahs M., Shin C., Landrigan P. J. Occupational injury and illness in the United States. Estimates of costs, morbidity, and mortality. Arch Intern Med. 1997 Jul 28;157(14):1557–1568. [PubMed] [Google Scholar]
  12. Markowitz S. B., Fischer E., Fahs M. C., Shapiro J., Landrigan P. J. Occupational disease in New York State: a comprehensive examination. Am J Ind Med. 1989;16(4):417–435. doi: 10.1002/ajim.4700160408. [DOI] [PubMed] [Google Scholar]
  13. Norström T. Deriving relative risks from aggregate data. 1. Theory. J Epidemiol Community Health. 1988 Dec;42(4):333–335. doi: 10.1136/jech.42.4.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Olsen O., Kristensen T. S. Impact of work environment on cardiovascular diseases in Denmark. J Epidemiol Community Health. 1991 Mar;45(1):4–10. doi: 10.1136/jech.45.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rutstein D. D., Mullan R. J., Frazier T. M., Halperin W. E., Melius J. M., Sestito J. P. Sentinel Health Events (occupational): a basis for physician recognition and public health surveillance. Am J Public Health. 1983 Sep;73(9):1054–1062. doi: 10.2105/ajph.73.9.1054. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Steineck G., Plato N., Norell S. E., Hogstedt C. Urothelial cancer and some industry-related chemicals: an evaluation of the epidemiologic literature. Am J Ind Med. 1990;17(3):371–391. doi: 10.1002/ajim.4700170310. [DOI] [PubMed] [Google Scholar]
  17. Winkleby M. A., Ragland D. R., Syme S. L. Self-reported stressors and hypertension: evidence of an inverse association. Am J Epidemiol. 1988 Jan;127(1):124–134. doi: 10.1093/oxfordjournals.aje.a114772. [DOI] [PubMed] [Google Scholar]

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