What this page tells you

The 4 main data sources for occupational lung disease are as follows:

• The Labour Force Survey as discussed above.
• The Industrial Injuries Disablement Benefit (IIDB) which captures people who are able to seek disability benefits.
• The Health and Occupation Research Network (THOR) which looks at cases referred into chest physicians. 
• Annual deaths which combines death certificates with an attributed fraction of deaths from respiratory disease, determined by epidemiological research.

Click through to learn more about these data capture schemes.

New cases of occupational lung disease vary year on year, but have been around 19,000 for the past few years.

The LFS includes the broadest definition of occupational lung disease and offers the current best insight into the total number of people whose respiratory health is affected by work.

To improve the value of this data we need follow up studies on these cases, looking at workplace exposures, diagnosis, treatment and recovery rates as well as information on any workplace adjustments and safety measures put in place.

The Health and Safety Executive estimates there are 12,000 annual deaths from occupational lung disease in the UK. This is calculated through a combination of death certificates and an attributed number of deaths from respiratory diseases based on epidemiological research.

For diseases where workplace exposures are the known cause, death certificates are used. This is the case with disease like mesothelioma, whereby asbestos exposure is the cause. For other diseases where there are many causes, such as COPD, researchers attribute a proportion of the total cases and deaths to workplace exposures. In this case of COPD, this is 15% of all cases and deaths are considered to be as a result of work. 

It is important to remember that current deaths can be different from current exposures or even current cases due to the long latency or slow progression of many respiratory diseases.

In 2021, 3,490 people claimed Industrial Injuries Disablement Benefit (IIDB) in Great Britain. According to HSE, data collection has been heavily impacted by the COVID-19 pandemic, particularly for 2020 there were significantly fewer people claiming than the 3,955 claiming in 2019. You can find advice on claiming this benefit on the Asthma and Lung UK website. 

The above gives us some insight into occupational lung diseases, but many people with work-related breathing problems would not be captured through this scheme. This was even fewer during the first year of the pandemic as HSE state that the pandemic was likely to have affected the number of people claiming and the assessment process. People are only eligible to claim this benefit if the link to work is sufficiently strong and the level of compensation available for even those who are severely disabled may also not provide enough incentive for all eligible individuals to apply. People who are self-employed are not covered by the IIDB scheme.

The Health and Occupation Research Network (THOR) looks at cases seen by chest physicians.

In 2020, only 250 people were seen by chest physicians regarding occupational lung disease, far fewer than 1,082 seen in 2019. Again, these figures will have been impacted significantly by the COVID-19 pandemic and cannot accurately reflect incidence. Potentially this is due to the redeployment of some physicians, the closure of clinics or that access to referrals were hindered.  Over time prior to the pandemic cases recorded through THOR had dropped, however, according to the Health and Safety Executive. Some of this is due to reporter fatigue, whereby doctors using the scheme lose motivation to record cases, rather than genuine drops in cases. Nonetheless, the overall trend is still a fall in cases over time. 

Cases captured within THOR tend to be shorter latency diseases such as asthma and allergic alveolitis or instances where cases can be readily attributed to work on a case-by-case basis.

The number of cases captured within THOR, IIDB and mortality statistics falls short of addressing the 19,000 new cases a year seen within the LFS, especially during the COVID-19 pandemic.

The estimated mortality statistics show us that there are at least 12,000 cases of occupational lung disease per year. However, a lot of these diseases will have developed a long time ago, so this data may not be relevant to disease rates now. As a result, we cannot use this data to accurately compare to current cases found within the LFS or other data sets. An example of this is COPD, which often progresses relatively slowly, yet accounts for 4,000 out of these 12,000 deaths annually. These cases will not be new cases but cases which developed several years ago.  

In comparison, Mesothelioma can progress rapidly. For diseases like mesothelioma and asbestos-related lung cancer, annual deaths are close to new annual cases.

Prevalence of occupational lung disease has not improved since 2008

The proportion of the working population that are currently living with an occupational lung disease is known as the prevalence.

The proportion of people living and working with an occupational lung disease has fallen by around a third since 2001 according to data from the Labour Force Survey (LFS). In 2001 0.20% of current workers reported work related breathing or lung problems. This has dropped to 0.14% as of 2021. Despite this overall improvement, rates are at a similar level as they were in the early 2000s, with little sustained progress throughout this period. There was a slight decrease in prevalence throughout 2010 – 2013, but this has since increased again.

Prevalence figures tell us how many people are affected and need help

If occupational lung disease rates improve, this would suggest workplaces are getting safer. Prevalence figures are useful because they give a sense of the burden of disease - how many people are suffering from occupational lung disease and how many people will likely need support from public services including healthcare and disability benefits. In contrast to this, the number of new cases of occupational lung disease each year gives us a better indication of current exposures within the workplace and if any improvements are being made there.

We lack several years of data on the number of new cases of occupational lung disease each year

The number of new cases in a given year, as a proportion of the total population, is known as the incidence rate. The LFS publishes three-year rolling averages of incidence, but for single year figures there are many years where incidence data is missing for the LFS. The sample size (number of participants) for the survey from 2010 – 2014 and again in 2018 and 2019 was too small to provide reliable estimates for single years. We need to ensure that reliable data is captured on new case rates.

There has been little improvement in incidence rates for two decades

From what we can see, incidence rates halved between 2001 to 2004 but rose back to the levels seen in 2003. This suggests little sustained improvement has been made in nearly two decades. It’s important to note that current rates of self-reported lung problems aren’t necessarily an accurate representation of current workplace exposures. Sometimes lung conditions can take years to present with symptoms. Nonetheless, the lack of progress in incidence rates is still a cause for concern and we want to see better compliance with regulations and better monitoring of current exposures.

Decreasing incidence rates of occupational lung disease do not necessarily mean a decrease in the actual number of cases

A change in the incidence rate does not necessarily mean a change in the number of people that are living with occupational lung disease. If the incidence rate drops it means fewer new cases a year, but at the same time prevalence can remain constant, meaning that the same proportion of people are living with an occupational lung disease. Prevalence can remain constant even if incidence drops if people are living longer with their condition.

We need to accurately assess the scale of the problem and ensure our healthcare services are well equipped to support people

The incidence of self-reported occupational lung disease appears to be dropping slightly again, which means as a proportion of the general population fewer people are developing new work-related lung disease. This is positive and could mean that risk in the workplace is reducing, however incidence is still higher than it has been previously, and prevalence has remained fairly constant meaning many people are living with lung conditions they say were caused by or made worse by their work.

Even if the incidence of self-reported cases drops, resources and funding must be available to care for those people already living with an occupational lung disease as well as new cases.