Working conditions and tuberculosis mortality in England and Wales, 1890–1912: a retrospective analysis of routinely collected data

BMC Infectious Diseases

Research Article

Tom A. Yates¹  Helen R. Stagg¹  Joanna H. Mostowy¹  Charlotte Jackson¹  Ibrahim Abubakar²  Nick Andrews³ 

[1] Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, 4th Floor Mortimer Market, off Capper Street, WC1E 6JB, London, UK;Centre for Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, 4th Floor Mortimer Market, off Capper Street, WC1E 6JB, London, UK;MRC Clinical Trials Unit at University College London, Aviation House, 125 Kingsway, WC2B 6NH, London, UK;Tuberculosis Section, Public Health England, 61 Colindale Ave, NW9 5EQ, London, UK;Statistics, Modelling and Economics Department, Public Health England, 61 Colindale Ave, NW9 5EQ, London, UK;

关键词: Epidemiology;    Occupation;    Historical data;   

DOI  :  10.1186/s12879-016-1509-z

 received in 2016-01-14, accepted in 2016-04-13,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundModelling studies suggest that workplaces may be important sites of Mycobacterium tuberculosis transmission in high burden countries today. Contemporary data on tuberculosis by occupation from these settings are scarce. However, historical data on tuberculosis risk in different occupations are available and may provide insight into workplace transmission. We aimed to ascertain whether, in a high burden setting, individuals working in crowded indoor environments (exposed) had greater tuberculosis mortality than individuals employed elsewhere (unexposed).MethodsThe Registrar General’s Decennial Supplements from 1890–2, 1900–2 and 1910–2 contain data on mortality from tuberculosis by occupation for men in England and Wales. In these data, the association between occupational exposure to crowded indoor environments and tuberculosis mortality was assessed using an overdispersed Poisson regression model adjusting for socioeconomic position, age and decade.ResultsThere were 23,962 deaths from tuberculosis during 14.8 million person-years of follow-up among men working in exposed occupations and 28,483 during 19.9 million person-years of follow-up among men working in unexposed occupations. We were unable to categorise a large number of occupations as exposed or unexposed. The adjusted rate ratio for death from tuberculosis was 1.34 (95 % confidence interval 1.26–1.43) comparing men working in exposed occupations to those in unexposed occupations.ConclusionsTuberculosis mortality in England and Wales at the turn of the 20th century was associated with occupational exposure to crowded indoor environments. The association between working conditions and TB in contemporary high burden settings requires further study.

【 授权许可】

CC BY   
© Jackson et al. 2016