Trends in suspected and recognized occupational respiratory diseases in Germany between 1970 and 2005

Our plain-English summary of Trends in suspected and recognized occupational respiratory diseases in Germany between 1970 and 2005, by V. van Kampen, R. Merget, M. Butz, et al (American Journal of Industrial Medicine, 2008).

The study

• Authors: V. van Kampen, R. Merget, M. Butz, D. Taeger, T. Brüning
• Journal: American Journal of Industrial Medicine
• Published: 2008;51(7):492-502
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Respiratory diseases represent a major proportion of occupational diseases in many countries. Little information is available about their incidences over the past several decades.

Methods: Based on the reports of the three German federal accident insurance agencies, the numbers of suspected and recognized cases of occupational respiratory diseases between 1970 and 2005 were collected and combined. The trends in the rates per 100,000 insured workers were calculated.

Results: In total, a decline in occupational respiratory diseases since 1998 could be observed. This trend is mainly based on the decrease in non-malignant respiratory diseases due to silica and obstructive airway diseases. In contrast, asbestos-induced diseases showed a leveling off or an increase (mesothelioma) during the last 10years.

Conclusions: Although trends in occupational disease may be influenced by several factors, the presented data indicate that prevention has been effective in reducing some ofthe most frequent occupational respiratory diseases in Germany.

(c) 2008 Wiley-Liss, Inc.

In plain English

This was a descriptive analysis of German occupational disease registry data. The authors combined reports from Germany's three federal accident insurance agencies on suspected and recognized cases of occupational respiratory diseases from 1970 to 2005. They calculated yearly rates per 100,000 insured full-time-equivalent workers. Overall, these diseases declined from 1998, mainly because of fewer non-malignant silica-related diseases and obstructive airway diseases. Asbestos-related diseases did not decline. Asbestosis including pleural disease rose until 1994 and then stayed at about 10 suspected and 6 recognized cases per 100,000 workers. Suspected lung or larynx cancer due to asbestos reached 8 per 100,000 in 2005, while recognized cases held at about 2 per 100,000 from 1994. Mesothelioma of the pleura, peritoneum or pericardium rose steadily, and 70.9% of suspected cases from 1996 to 2005 were recognized. The authors concluded that prevention had been effective against some of the most frequent occupational respiratory diseases. They noted that the data may underestimate true numbers and that legal changes partly shaped the trends.

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: Descriptive trend analysis of national occupational disease insurance registry data (suspected and recognized cases, with rates per 100,000 insured full-time-equivalent workers)
• Who was studied: Workers insured by Germany's three federal accident insurance agencies (industry and trade, farm, and public sectors), 1970 to 2005. The farm sector was added from 1983, the public sector from 1995, and former East German data after reunification. In 2005 about 32 million full-time equivalents were insured in industry and trade, about 5 million in the public sector and 1.9 million in the farm sector.
• Exposure: Exposures defined by the 18 German legal categories of occupational respiratory disease: asbestos dust (asbestosis or pleural disease, lung or larynx cancer, and mesothelioma), quartz/silica dust, other inorganic agents (aluminium, hard metals, basic slag, nickel, coke oven gas), organic dusts, allergens, irritants and isocyanates. Asbestos fiber types are not specified.
• Main results:
  • All occupational respiratory diseases combined declined from 1998. This was mainly due to decreases in non-malignant silica-related diseases and obstructive airway diseases.
  • The annual rate of suspected occupational respiratory disease cases rose from 30.8 per 100,000 FTE in 1980 to 54.8 in 1994.
  • Asbestosis including pleural disease (BK no. 4103): rates rose until 1994, then stayed relatively constant at about 10 suspected and 6 recognized cases per 100,000 FTE.
  • Asbestosis including asbestos-induced pleural disease (BK no. 4103) had 3,638 suspected cases in 2005.
  • Lung or larynx cancer due to asbestos (BK no. 4104): rates were below 0.02 per 100,000 FTE until 1985. The suspected-case rate then rose to 8 per 100,000 FTE in 2005 (2,969 suspected cases that year).
  • Lung or larynx cancer due to asbestos (BK no. 4104): since 1994, recognized cases held at a constant rate of 2 per 100,000 FTE per year.
  • Mesothelioma of pleura, peritoneum or pericardium (BK no. 4105): rates of suspected and recognized cases rose steadily from the start of data collection in 1977.
  • Mesothelioma (BK no. 4105): the share of suspected cases that were recognized was high, at 70.9% for 1996 to 2005 (Table I).
  • From 1998 to 2005, against the general downward trend, rates of asbestosis and of lung and larynx cancer due to asbestos stayed stable, while mesothelioma rates increased.
  • Allergic obstructive airway disease (BK no. 4301) peaked at 18.4 suspected cases per 100,000 FTE in 1990 and declined steadily afterwards.
• The authors' conclusion: The authors concluded that, although several factors may influence occupational disease trends, the data indicate that prevention was effective in reducing some of the most frequent occupational respiratory diseases in Germany.
• Limitations the authors state:
  • The data may underestimate the true number of cases, because a disease's occupational cause might have been overlooked.
  • Because of the latency period of most of these diseases, there is no direct time link between the number of insured workers and registered cases.
  • Farm sector and public sector cases and workers were not included until 1983 and 1995, which may explain some shifts in rates.
  • The earlier rise in asbestosis and in lung and larynx cancer due to asbestos was partly caused by a 1988 change in the legal definition, which extended recognition to asbestos-associated pleural diseases.
  • Diagnostic tools such as high resolution computed tomography have changed the numbers of asbestos-related pleural disease cases.
  • The data cannot simply be read as measures of occupational exposure load or of how well prevention worked.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Disease, Mesothelioma.

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