Publications
191 results found
Rushton L, Hutchings SJ, 2017, The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation, BRITISH JOURNAL OF CANCER, Vol: 116, Pages: 536-539, ISSN: 0007-0920
Background: Increasing evidence highlights the association of occupational exposure and cutaneous malignant melanoma (CMM). We estimated the burden of CMM and total skin cancer burden in Britain due to occupational solar radiation exposure.Methods: Attributable fractions (AF) and numbers were estimated for CMM mortality and incidence using risk estimates from the published literature and national data sources for proportions exposed. We extended existing methods to account for the exposed population age structure.Results: The estimated total AF for CMM is 2.0% (95% CI: 1.4–2.7%), giving 48 (95% CI: 33–64) deaths in (2012) and 241 (95% CI: 168–325) registrations (in 2011) attributable to occupational exposure to solar radiation. Higher exposure and larger numbers exposed led to much higher numbers for men than women. Industries of concern are construction, agriculture, public administration and defence, and land transport.Conclusions: These results emphasise the urgent need to develop appropriate strategies to reduce this burden.
Carey RN, Hutchings SJ, Rushton L, et al., 2017, The future excess fraction of occupational cancer among those exposed to carcinogens at work in Australia in 2012, CANCER EPIDEMIOLOGY, Vol: 47, Pages: 1-6, ISSN: 1877-7821
De Matteis S, Jarvis D, Darnton A, et al., 2016, THE OCCUPATIONS AT INCREASED COPD RISK IN THE LARGE POPULATION-BASED UK BIOBANK COHORT, Publisher: BMJ PUBLISHING GROUP
Shield KD, Parkin DM, Whiteman DC, et al., 2016, Population Attributable and Preventable Fractions: Cancer Risk Factor Surveillance, and Cancer Policy Projection, Current Epidemiology Reports, Vol: 3, Pages: 201-211, ISSN: 2196-2995
The proportions of new cancer cases and deaths that are caused by exposure to risk factors and that could be prevented are key statistics for public health policy and planning. This paper summarizes the methodologies for estimating, challenges in the analysis of, and utility of, population attributable and preventable fractions for cancers caused by major risk factors such as tobacco smoking, dietary factors, high body fat, physical inactivity, alcohol consumption, infectious agents, occupational exposure, air pollution, sun exposure, and insufficient breastfeeding. For population attributable and preventable fractions, evidence of a causal relationship between a risk factor and cancer, outcome (such as incidence and mortality), exposure distribution, relative risk, theoretical-minimum-risk, and counterfactual scenarios need to be clearly defined and congruent. Despite limitations of the methodology and the data used for estimations, the population attributable and preventable fractions are a useful tool for public health policy and planning.
Sadhra SS, Kurmi OP, Chambers H, et al., 2016, Development of an occupational airborne chemical exposure matrix, Occupational Medicine, Vol: 66, Pages: 358-364, ISSN: 0962-7480
BackgroundPopulation-based studies of the occupational contribution to chronic obstructive pulmonary disease generally rely on self-reported exposures to vapours, gases, dusts and fumes (VGDF), which are susceptible to misclassification.AimsTo develop an airborne chemical job exposure matrix (ACE JEM) for use with the UK Standard Occupational Classification (SOC 2000) system.MethodsWe developed the ACE JEM in stages: (i) agreement of definitions, (ii) a binary assignation of exposed/not exposed to VGDF, fibres or mists (VGDFFiM), for each of the individual 353 SOC codes and (iii) assignation of levels of exposure (L; low, medium and high) and (iv) the proportion of workers (P) likely to be exposed in each code. We then expanded the estimated exposures to include biological dusts, mineral dusts, metals, diesel fumes and asthmagens.ResultsWe assigned 186 (53%) of all SOC codes as exposed to at least one category of VGDFFiM, with 23% assigned as having medium or high exposure. We assigned over 68% of all codes as not being exposed to fibres, gases or mists. The most common exposure was to dusts (22% of codes with >50% exposed); 12% of codes were assigned exposure to fibres. We assigned higher percentages of the codes as exposed to diesel fumes (14%) compared with metals (8%).ConclusionsWe developed an expert-derived JEM, using a strict set of a priori defined rules. The ACE JEM could also be applied to studies to assess risks of diseases where the main route of occupational exposure is via inhalation.
De Matteis S, Jarvis DJ, Hutchings SH, et al., 2016, Occupations associated with COPD risk in the large population-based UK Biobank cohort study, Occupational and Environmental Medicine, Vol: 73, Pages: 378-384, ISSN: 1351-0711
Objectives COPD is a leading cause of morbidity and mortality worldwide. Exposure to occupational hazards is an important preventable risk factor but the contribution of specific occupations to COPD risk in a general population is uncertain. Our aim was to investigate the association of COPD with occupation in the UK population. Methods In 2006-2010 the UK Biobank cohort recruited 502,649 adults aged 40-69 years. COPD cases were identified by pre-bronchodilator FEV1/FVC<lower limit of normal (LLN) according to ATS/ERS guidelines. Current occupations were coded using the Standard Occupational Classification (SOC) 2000. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of COPD for each SOC-coded job were estimated using a robust Poisson model adjusted for sex, age, recruitment centre and lifetime tobacco smoking. Analyses restricted to never smokers and non-asthmatics were also performed. Results Of the 353 occupations reported by 228,614 current working participants, several showed significantly increased COPD risk. Those at highest COPD risk were seafarers (PR=2.64;95%CI:1.59-4.38), coal mine operatives (PR=2.30;95%CI:1.00-5.31), cleaners (industrial: PR=1.96;95%CI:1.16-3.31 and domestic: PR=1.43;95%CI:1.28-1.59), roofers/tilers (PR=1.86;95%CI:1.29-2.67), packers/bottlers/canners/fillers (PR=1.60;95%CI:1.15-2.22), horticultural trades (PR=1.55;95%CI:0.97-2.50), food/drink/tobacco process operatives (PR=1.46;95%CI:1.11-1.93), floorers/wall tilers (PR=1.41;95%CI:1.00-2.00), chemical/related process operatives (PR=1.39;95%CI:0.98-1.97), postal workers/couriers (PR=1.35;95%CI:1.15-1.59), labourers in building/woodworking trades (PR=1.32;95%CI:1.04-1.68), school mid-day assistants (PR=1.32;95%CI:1.01-1.74), and kitchen/catering assistants (PR=1.30;95%CI:1.10-1.53). Associations were similar in analyses restricted to never smokers and non-asthmatics.Conclusions Selected occupations are associated with increased COPD risk in a large cross-sectional population-
Madan I, Parsons V, Cookson B, et al., 2016, A behavioural change package to prevent hand dermatitis in nurses working in the national health service (the SCIN trial): study protocol for a cluster randomised controlled trial, Trials, Vol: 17, ISSN: 1745-6215
Background: Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin carestrategies and policy directives have been developed in recent years to minimise the risk, their effectiveness andcost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour changewith respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural changeintervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions,coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of handdermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) whoare particularly at risk. Secondary aims will be to assess impacts on participants’ beliefs and behaviour regardinghand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care.Methods/Design: We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nursesin intensive care units.Nurses at ‘intervention-light’ sites will be managed according to what would currently be regarded as best practice, withprovision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact theiroccupational health (OH) department early if hand dermatitis occurs. Nurses at ‘intervention-plus’ sites will additionallyreceive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhancedprovision of moisturising cream.The impact of the interventions will be compared using information collected by questionnaires and throughstandardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition,we
Forouzanfar MH, Alexander L, Anderson HR, et al., 2015, Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, LANCET, Vol: 386, Pages: 2287-2323, ISSN: 0140-6736
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- Citations: 1850
De Matteis S, Jarvis D, Hutchings S, et al., 2015, The occupations associated with COPD risk in the large population-based UK Biobank cohort study, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ Publishing Group, Pages: A103-A103, ISSN: 1468-3296
De Matteis S, Jarvis D, Hutchings S, et al., 2015, Work-related COPD risk in the population-based UK Biobank cohort study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
De Matteis S, Jarvis D, Wheatley M, et al., 2015, A new web-based tool to collect and code lifetime job-histories in large populationbased studies, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Mak TSH, Best N, Rushton L, 2015, Robust Bayesian Sensitivity Analysis for Case-Control Studies with Uncertain Exposure Misclassification Probabilities, INTERNATIONAL JOURNAL OF BIOSTATISTICS, Vol: 11, Pages: 135-149, ISSN: 2194-573X
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- Citations: 4
Grellier J, Rushton L, Briggs DJ, et al., 2015, Assessing the human health impacts of exposure to disinfection by-products - A critical review of concepts and methods, ENVIRONMENT INTERNATIONAL, Vol: 78, Pages: 61-81, ISSN: 0160-4120
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- Citations: 85
Fortunato L, Rushton L, 2015, Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies, British Journal of Cancer, Vol: 112, Pages: 1805-1815, ISSN: 1532-1827
background: A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer.methods: We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression.results: We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03–1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000.conclusions: Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.
Purdue MP, Hutchings SJ, Rushton L, et al., 2015, The proportion of cancer attributable to occupational exposures, ANNALS OF EPIDEMIOLOGY, Vol: 25, Pages: 188-192, ISSN: 1047-2797
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- Citations: 57
Pearce N, Blair A, Vineis P, et al., 2015, IARC Monographs: 40 Years of Evaluating Carcinogenic Hazards to Humans, Environmental Health Perspectives, Vol: 123, Pages: 507-514, ISSN: 1552-9924
Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.Objectives: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed.Discussion: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.Conclusions: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public’s health.
GBD 2013 Mortality and Causes of Death Collaborators, 2015, Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013, The Lancet, Vol: 385, Pages: 117-171, ISSN: 0140-6736
SummaryBackground Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-co
Nankervis H, Pynn EV, Boyle RJ, et al., 2015, House dust mite reduction and avoidance measures for treating eczema, Cochrane Database of Systematic Reviews, ISSN: 1469-493X
De Matteis S, Jarvis D, Wheatley M, et al., 2014, A New, Efficient Web-based Tool To Collect And Code Lifetime Job Histories In Large Population-based Studies: The Copd Project In The Uk Biobank Cohort, British Thoracic Society Winter Meeting 2014, Publisher: BMJ Publishing Group, Pages: A4-A4, ISSN: 1468-3296
Sadhra S, Fishwick D, Kurmi OP, et al., 2014, DEVELOPMENT OF A JOB EXPOSURE MATRIX FOR SOC 2000 LISTINGS TO IDENTIFY OCCUPATIONAL CAUSES OF COPD, Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A4-A4, ISSN: 0040-6376
Wang H, Liddell CA, Coates MM, et al., 2014, Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, LANCET, Vol: 384, Pages: 957-979, ISSN: 0140-6736
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- Citations: 435
Rumsby P, Rockett L, Clegg H, et al., 2014, Speciation of manganese in drinking water, 50th Congress of the European-Societies-of-Toxicology, Publisher: ELSEVIER IRELAND LTD, Pages: S120-S120, ISSN: 0378-4274
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- Citations: 6
Boobis A, Craig P, Flari V, et al., 2014, Interpretation of margins of exposure for genotoxic carcinogens, 50th Congress of the European-Societies-of-Toxicology, Publisher: ELSEVIER IRELAND LTD, Pages: S105-S105, ISSN: 0378-4274
Rushton L, 2014, The problem with diesel, 50th Congress of the European-Societies-of-Toxicology, Publisher: ELSEVIER IRELAND LTD, Pages: S24-S24, ISSN: 0378-4274
Rushton L, 2014, Occupational cancer: key challenges and opportunities for change, OCCUPATIONAL MEDICINE-OXFORD, Vol: 64, Pages: 313-316, ISSN: 0962-7480
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- Citations: 2
Nankervis H, Pynn EV, Boyle RJ, et al., 2014, House dust mite reduction and avoidance measures for treating eczema: a Cochrane review, 8th Georg Rajka Symposium on Atopic Dermatitis (ISAD), Publisher: WILEY-BLACKWELL, Pages: E50-E51, ISSN: 0007-0963
Parsons V, Coggon D, Cookson B, et al., 2014, The SCIN (Skin Care Intervention in Nurses) trial. A cross-sectional feasibility study in Wales (stage 1), 8th Georg Rajka Symposium on Atopic Dermatitis (ISAD), Publisher: WILEY-BLACKWELL, Pages: E34-E35, ISSN: 0007-0963
De Matteis S, Rushton L, Jarvis D, et al., 2014, 0154 A new, efficient web-based tool to collect and code lifetime job histories in large population-based studies: the COPD project in the UK Biobank cohort.
OBJECTIVES: The manual collection and coding of job histories is the standard method for assessing occupational exposure, but may be infeasible for large population-based studies such as the UK Biobank cohort. We aimed to develop a new web-based tool to automatically collect and code individual lifetime job histories in the UK Biobank cohort for investigating the causes and burden of work-related COPD in the UK. METHOD: UK Biobank is a population-based cohort of 502 682 subjects, aged 40-69 years, recruited in 2006-2010. Baseline spirometry data, current employment and smoking histories were collected. We developed a job questionnaire based on the hierarchical structure of the standard occupational classification (SOC) 2000 to allow participants to automatically self-collect and code their lifetime job histories. The web-based prototype (www.imperial.ac.uk/biobank/questionnaire) was pre-piloted in May-August 2013 among key job sectors using snowball sampling together with a feedback survey. RESULTS: 171 subjects participated in both the pre-piloting and feedback survey. 91% completed the questionnaire in <20 min, 85% considered the instructions clear, and 80% found their job categories/titles easily. Overall, 96% judged the questionnaire to be clear and easy. A revised questionnaire has now been designed and will be accessible from different media including PCs/laptops, tablets and smart phones to encourage high response. A demonstration version will be made available to conference participants. CONCLUSIONS: Our web-based job questionnaire is an efficient new standard tool for collecting and automatically coding lifetime job histories in large population-based studies and is adaptable for use in many occupational health research projects.
Hutchings S, Rushton L, Driscoll T, 2014, 0261 Estimating the burden of occupational cancer taking into account age0261 Estimating the burden of occupational cancer taking into account age.
OBJECTIVES: Estimates of burden of disease are generally based on population attributable fractions (PAFs) calculated for a whole population. However, the age structure of an exposed group has an impact on these estimates, because disease rates vary by age and the exposed population may be younger than the national population in the estimation year. METHOD: To account for this, PAFs can be calculated by age, and applied separately by age to national incidence data. We have adapted our risk period methodology, which takes account of latency to estimate numbers exposed to a causative agent using Levin's formula for PAF, to estimate a workforce turnover factor by age group, which accounts for the age structure of an exposed population. To estimate age-specific RRs from unit relative risks per year of exposure, the link between age and duration of exposure can be modelled using Monte-Carlo methods. RESULTS: We show the effect of estimating the burden of lung cancer due to occupational exposure to respirable crystalline silica for Britain using PAF estimates which do or do not take age into account. Taking account of age and assuming recruitment between ages 15-44, there were 1188 lung cancer registrations in males in 2010, or 798 without accounting for age, or 636 vs. 804 assuming recruitment between ages 15-24. The extension to using age-specific RRs is demonstrated for occupational asbestos-related lung cancers. CONCLUSIONS: Given the above results, and although highly dependent on assumptions made about workforce ages, there is clearly a case to be made to estimate PAFs by age.
Kim J, Peters CE, McLeod C, et al., 2014, 0309 Burden of cancer attributable to occupational diesel engine exhaust exposure in Canada0309 Burden of cancer attributable to occupational diesel engine exhaust exposure in Canada.
OBJECTIVES: To estimate the number of new lung cancers cases in Canada attributable to occupational diesel engine exhaust (DEE), which IARC classified as a definite human carcinogen in 2012. This is part of a larger effort to estimate the current burden of occupational cancers in Canada. METHOD: Relative risks were selected from two recent studies of miners and truckers with quantitative exposure-response. CAREX Canada estimates of exposure prevalence and level by detailed industry and occupation were supplemented by a literature search for DEE measurement data. For each exposure group, RRs were assigned based upon the estimated mean exposure. Employment trends of industries and occupations were based upon census data from multiple years. Annual Labour Force Survey data were used to attribute age- and tenure-distribution, as well as short-term turnover characteristics. Survival was adjusted to age at entry into the exposed cohort during the risk exposure period 1961-2001. The attributable fraction (AF) for DEE-related lung cancers will be calculated by province, sex, industry and occupation. RESULTS: Approximately 1.4 million workers were exposed to DEE during the risk exposure period. The initial estimated AFs for DEE-related lung cancers are: 4.92% for males, 0.29% for females, and 2.70% overall. CONCLUSIONS: These burden estimates are somewhat higher than recent estimates from other groups (1.3-1.8%). They account for the most recent evidence for the risk of lung cancer from occupational DEE exposure, as well as detailed historical exposure assessment and labour force trends. Sensitivity analyses are underway to determine the influential assumptions.
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