Occupation and work-related ill-health in UK construction workers

Our plain-English summary of Occupation and work-related ill-health in UK construction workers, by S.J. Stocks, S. Turner, R. McNamee, et al (Occupational Medicine, 2011).

The study

• Authors: S.J. Stocks, S. Turner, R. McNamee, M. Carder, L. Hussey, R.M. Agius
• Journal: Occupational Medicine
• Published: 2011;61(6):407-15
• Cited by: 43 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Construction workers are at increased risk of work-related ill-health (WRI) worldwide.

Aims: To compare the incidence of medically reported WRI in occupations within the UK construction industry according to job title.

Methods: We calculated standardized incidence rate ratios (SRRs) using WRI cases for individual job titles returned to The Health and Occupation Reporting network by clinical specialists and UK population denominators. We counted frequencies of reported causal exposures or tasks reported by clinical specialists, occupational physicians and general practitioners.

Results: We found significantly increased incidence of WRI compared with other workers in the same major Standard Occupational Classification, i.e. workers with similar levels of qualifications, training, skills and experience, for skin neoplasia in roofers (SRR 6.3; 95% CI: 3.1-13.1), painters and decorators (2.1; 95% CI: 1.2-3.6) and labourers in building and woodworking trades (labourers, 6.6; 95% CI: 3.2-13.2); contact dermatitis in metal workers (1.4; 95% CI: 1.1-1.7) and labourers (1.6; 95% CI: 1.1-2.3); asthma in welders (3.8; 95% CI: 2.8-5.0); musculoskeletal disorders in welders (1.7; 95% CI: 1.1-2.8), road construction operatives (6.1; 95% CI: 3.8-9.6) and labourers (2.5; 95% CI: 1.7-3.7); long latency respiratory disease (mesothelioma, pneumoconiosis, lung cancer, non-malignant pleural disease) in pipe fitters (4.5; 95% CI: 3.2-6.2), electrical workers (2.7; 95% CI: 2.4-3.2), plumbing and heating engineers (2.3; 95% CI: 1.9-2.7), carpenters and joiners (2.7; 95% CI: 2.3-3.1), scaffolders (12; 95% CI: 8-18) and labourers (3.3; 95% CI: 2.6-4.1).

Conclusions: UK construction industry workers have significantly increased risk of WRI. These data in individual construction occupations can be used to inform appropriate targeting of occupational health resources.

In plain English

This study analysed 2002–2008 reports to THOR, a voluntary UK scheme in which doctors report illness they judge work-related. Only men were analysed; women made up 1% of reports. The authors calculated standardized incidence rate ratios for workers aged 65 or under in construction-related job groups with at least five specialist reports, against all UK workers and against similar-skill workers. Against similar-skill workers, rate ratios for long latency respiratory disease (mesothelioma, pneumoconiosis, lung cancer and non-malignant pleural disease) were significantly raised in pipe fitters (4.5; 95% confidence interval 3.2–6.2), electrical workers (2.7; 2.4–3.2), plumbing and heating engineers (2.3; 1.9–2.7), carpenters and joiners (2.7; 2.3–3.1), scaffolders (12; 8–18) and building and woodworking labourers (3.3; 2.6–4.1). Doctors attributed 2410 of 2460 long latency respiratory cases (98%) in skilled tradesmen to asbestos. Rate ratios were also raised for skin neoplasia in roofers (6.3; 3.1–13.1) and asthma in welders (3.8; 2.8–5.0). The authors noted that the past exposed workforce may differ from today's, possibly distorting long latency results. They concluded that UK construction workers have significantly increased risk of work-related ill-health.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Analysis of national voluntary surveillance data (THOR network reports of medically diagnosed work-related ill-health), with standardized incidence rate ratios calculated using UK Labour Force Survey 2005 denominators
• Who was studied: Male UK workers in skilled construction and building trades, skilled metal and electrical trades, and other construction-related job titles, as reported to THOR from 2002 to 2008. More than 1400 clinical specialists returned 18 509 actual case reports in total. Of these, 1850 were in construction and building trades and 2514 in metal and electrical trades. Rate ratios were calculated only from clinical specialist reports, and only for occupational groups with at least five actual reports.
• Exposure: Job title within construction-related occupations. Reporting doctors named suspected causes. Asbestos was named for most long latency respiratory disease, silica for some pneumoconiosis, and sunlight or ultraviolet light for most skin neoplasia. Fiber types were not specified.
• Main results:
  • Compared with workers in the same major occupational group, long latency respiratory disease (mesothelioma, pneumoconiosis, lung cancer, non-malignant pleural disease) was significantly raised in pipe fitters (SRR 4.5; 95% CI 3.2–6.2) and electrical workers (2.7; 95% CI 2.4–3.2)
  • Long latency respiratory disease was also significantly raised in plumbing and heating engineers (2.3; 95% CI 1.9–2.7), carpenters and joiners (2.7; 95% CI 2.3–3.1), scaffolders (12; 95% CI 8–18) and labourers in building and woodworking trades (3.3; 95% CI 2.6–4.1)
  • These raised rates of long latency respiratory disease were significant with either comparison group: all UK workers, or workers in the same major occupational group
  • In skilled tradesmen, 98% (2410/2460) of long latency respiratory disease was attributed to asbestos exposure, and 1% (25/2460) to pneumoconiosis attributed to silica. Most pneumoconiosis reports to THOR were attributed to asbestos (85%), then silica (11%).
  • Skin neoplasia was significantly raised in roofers (SRR 6.3; 95% CI 3.1–13.1), painters and decorators (2.1; 95% CI 1.2–3.6) and labourers in building and woodworking trades (6.6; 95% CI 3.2–13.2). Almost all of it was attributed to sunlight or ultraviolet light.
  • Asthma was significantly raised in welders (3.8; 95% CI 2.8–5.0)
  • Musculoskeletal disorders were significantly raised in welders (1.7; 95% CI 1.1–2.8), road construction operatives (6.1; 95% CI 3.8–9.6) and labourers (2.5; 95% CI 1.7–3.7)
  • Contact dermatitis was significantly raised in metal workers (1.4; 95% CI 1.1–1.7) and labourers (1.6; 95% CI 1.1–2.3)
• The authors' conclusion: The authors concluded that UK construction industry workers have significantly increased risk of work-related ill-health. They also concluded that labourers in building and woodworking trades are at particular risk, and that the data can help target occupational health resources.
• Limitations the authors state:
  • For long latency disease, the rate ratios may be affected because the population exposed in the past may differ from the current Labour Force Survey workforce used as the denominator
  • The comparison populations are affected by the healthy worker survivor effect: people leaving work through death, disability, retirement or job changes
  • The increased rates in the 'not elsewhere classified' labourer and operative groups may be due to misclassification
  • The confidence intervals do not account for errors in the Labour Force Survey estimates, or for the possibility that the reporting doctors are not representative
  • Knowing a patient's occupation may influence how doctors attribute the cause and work-relatedness of an illness

Topics

The National Library of Medicine indexes this study under subjects our site covers: Construction.

Medical terms in this study, explained in our Lexicon: Incidence, Latency, Mesothelioma, Pneumoconiosis, Lung Cancer.

Related studies

• Work-related respiratory health conditions among construction workers: a systematic narrative review — E.F. Boadu, S.R. Okeke, et al. (2023)
• Medically reported work-related ill-health in the UK agricultural sector — S.J. Stocks, S. Turner, et al. (2010)
• The incidence of medically reported work-related ill health in the UK construction industry — S.J. Stocks, R. McNamee, et al. (2010)
• The impact of asbestos exposure in Swedish construction workers — B. Järvholm, A. Englund (2014)
• The risk of lung cancer after cessation of asbestos exposure in construction workers using pleural malignant mesothelioma as a marker of exposure — B. Järvholm, E. Aström (2014)
• Chest physician-reported, work-related, long-latency respiratory disease in Great Britain — M. Carder, A. Darnton, et al. (2017)

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