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27th International Congress on Occupational Health. Iguassu Falls, Brasil: What are the proportions of work-related diseases? A national study based on hospitalization registries

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Title: 27th International Congress on Occupational Health. Iguassu Falls, Brasil: What are the proportions of work-related diseases? A national study based on hospitalization registries


1
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
27th International Congress on Occupational
Health Iguassu Falls, Brazil
What are the proportions of work-related
diseases? A national study based on
hospitalization registries
Tage S. Kristensen Otto M. Poulsen Harald
Hannerz Finn Tüchsen Vilhelm Borg National
Institute of Occupational Health Copenhagen,
Denmark
2
Key concepts
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
Etiologic fraction
The proportion of a disease that would not have
occurred if the risk factor had not been
present. (Analytic concept)
The proportion of a disease that would not have
occurred if everyone had the same disease risk as
a non-exposed reference (occupational)
group. (Descriptive concept)
Preventable fraction
3
Illustration of etiologic fraction
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
RR
2


40
1
40
60
0
-

Exposure (Causal risk factor)
EF 29
40
140
The elimination of the exposure is estimated to
reduce disease occurrence in the population with
29.
4
Illustration of preventable fraction
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
SMR




200
10
20
45
10
100
20
10
30
20
20
0
Occupational groups
PF 46
10102045
185
If all occupational groups had the same disease
risk as the non-exposed group, the disease
occurrence in the population would be 46 lower.
5
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
Study base
All persons in Denmark who were 20-59 years old
Jan 1, 1994. All hospitalizations during
1994-1999 in somatic hospitals. 58 occupational
groups. 11 main diagnoses from the
hospitalization registry. Teaching research
was considered as the non-exposed
group. Control for age and social class.
Stratified by gender.
6
Preventable fractions in Denmark
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
Males Males Females Females
Ischaemic heart disease 24 (17) 31 (22)
Cancer 8 (6) 3 (4)
Diseases in lungs and airways 16 (9) 12 (8)
Musculoskeletal diseases 21 (10) 19 (12)
Diseases in the nervous system 17 (12) 12 (7)
All diseases 15 (8) 11 (7)
Numbers in parentheses Controlled for social
class.
7
Comparisons with other estimates
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
(Controlled for social class)
Our estimate
Others
Ischaemic heart disease M 17 16
F 22 22
1)
1)
Cancer M 6 4
F 4 4
2)
Diseases in lungs airways M 9 10
F 8 10
3)
1) Olsen Kristensen. 2) Doll Peto. 3) Blanc
Toren
8
In conclusion
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
The number of hospitalizations in Denmark would
be reduced by 10-15 if all occupational groups
had the hospitalization rates of teaching
research The highest proportions were seen for
ischaemic heart diseases (24-31) and
musculoskeletal diseases (19-20). The estimates
(controlled for social class) were very similar
to etiologic fraction estimates from the
literature calculated with different
methods. The method seems to be promising when
knowledge about causal risk factors is lacking.

9
THE ENDThis presentation can be found
atwww.ami.dk/presentations
L\PSA01\8. PERSONLIGE ARKIVER\LNA\Forskere\Tage
Otto M. Poulsen
Harald Hannerz
Tage S. Kristensen
Finn Tüchsen
Vilhelm Borg
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