Occupational inhalational accidents: analysis of cases from the UK SWORD reporting scheme from 1999 to 2018.

Objective: To estimate the reported UK incidence of occupational inhalation accidents, and to consider changes of incidence and potential causes over time.

Methods: Cases of occupational inhalation accident reported to Surveillance of Work Related Occupational Respiratory Diseases (SWORD) over 20 years were grouped into four 5-year time periods. Cases were characterised by causative exposure, occupation and industrial sector. Incidence rates were calculated using Office of National Statistics employment data.

Results: The 172 actual cases reported to SWORD equated to an estimated 502 cases after adjusting for reporting frequency. Their mean age was 41.3 years (SD 12.3); 77% were male. The annual incidence fell from 1.7 per million employed in the first 5-year period, to 0.5 in the most recent. The most common occupations, responsible for 35% of all cases, were in descending order (number, % of total cases): Labourers in process and plant operations (8, 4.7), welding trades (8, 4.7), fire service officers (8, 4.7), heavy goods vehicle drivers (7, 4.1), metal working production and maintenance fitters (7, 4.1), civil service administrative officers and assistants (7, 4.1), food, drink and tobacco process operatives (6, 3.5), and three summated categories of elementary and service occupations including cleaners and domestics (10, 5.8).Three of 40 exposure categories were common to all time periods; acids (19.6% of all cases 1999-2004, 2.3% 2005-2009, 6.3% 2010-2013, 6.3% 2014-2018), chlorine/hypochlorites (7.2%, 7.0%, 2.5%, 6.3%, respectively) and solvents (14.4%, 11.6%, 12.5%, 6.3%, respectively).

Conclusions: The incidence of inhalation accidents appears to have fallen, although certain exposures appear to be persistently linked to cases.