Clinical Review Recent advances

Occupational disease

BMJ 1999; 318 doi: http://dx.doi.org/10.1136/bmj.318.7195.1397 (Published 22 May 1999) Cite this as: BMJ 1999;318:1397
  1. Nicola Cherry ([email protected]), professor
  1. Centre for Occupational Health, University of Manchester, Stopford Building, Manchester M13 9PT
  • Accepted 7 December 1998

An occupational disease may be defined simply as one that is caused, or made worse, by exposure at work. While epidemiological studies of populations can determine whether disease is attributable to a particular type or level of exposure, for an individual patient this is less clear. Judgments about the patterns of exposure likely to be causal may be made in medicolegal cases or claims for compensation but these decisions have little value in determining the true extent of disease caused by work, not least because of the absence of reliable exposure data. Information about the incidence and distribution of such diseases is thus far from complete. This review describes recent advances in the understanding of the patterns and causes of occupational disease.

Summary points

  • An understanding of the causes of occupational disease requires both good epidemiology and detailed knowledge of the nature of exposure and the susceptibility of those exposed

  • Concern about the effects of workplace exposures on male reproductive capacity remains great despite the paucity of evidence for hypotheses about male mediated effects on the fetus

  • Good evaluative studies of preventive programmes are needed but are in short supply

  • Future advances in prevention of chronic non-malignant disease may come in part through better understanding of the role of psychosocial factors in the workplace

  • Despite our best efforts, occupational disease persists and may contribute significantly to disability in elderly people long past retirement

Methods

This article is based on published information on occupational disease from general and specialist medical journals and from epidemiological, psychological, and ergonomic journals, and from my own ongoing research. A review was carried out of all articles published since January 1997 in four influential occupational health journals: Occupational and Environmental Medicine, American Journal of Industrial Medicine, Scandinavian Journal of Work and Environment and Health,and Annals of …

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