Document resource
Background The Occupational Lung Disease (OLD) service at Royal Brompton Hospital was established in the 1970s and is one of the largest referral centres in the UK. Around 60% of current referrals are from occupational health services following health surveillance for occupational asthma (OA). All confirmed cases of OLD identified at the clinic are recorded in a database and reported to the UK-wide SWORD (Surveillance of Work Related and Occupational Respiratory Disease) scheme. A previous publication suggested a downward trend in referrals to SWORD from 1999 to 2014 with a possible uplift from 2014–2016. 1 Methods We carried out a retrospective review of all OA cases seen in our clinic over 20 years from 1995–2025 to explore trends in incidence by causal agents.Results We identified a total of 800 cases with the total number of cases appearing to have declined over time: n=408 (1995–2005), n=229 (2005–2015) and n=168 (2015–2025). The most common causative allergens have consistently been bakery allergens and laboratory animals, followed by isocyanates, detergent enzymes, colophony and platinum groups salts. Incidence of OA from bakery allergens, laboratory animals and detergent enzymes has fallen; in contrast, OA due to wood, platinum group salts and colophony have remained relatively stable. Latex and pharmaceuticals are no longer frequent causes of OA in our service. ( figure 1) Analyses relating to age and sex of cases are ongoing.Abstract P73 Figure 1Causal agents for confirmed cases of OA by decade (1995–2025)Conclusion Incident OA in our clinic has fallen the last 30 years in keeping with SWORD data. 1 This likely reflects primary prevention of disease resulting from implementation of the hierarchy of control of exposures in workplaces including removal of exposures (e.g. powdered latex gloves in the NHS) and from introduction of engineering controls (e.g. individually ventilated cages for laboratory rodents). However secondary prevention using health surveillance remains important where there is residual risk of disease. This is particularly so in the baking industry, laboratory animal research and in workers exposed to isocyanates in whom we continue to diagnose significant number of cases of OA in our clinic annually.Reference Seed MJ, et al. Occup Environ Med. 2019;76:396–397.