title: Assessing the impact of national level interventions on workplace respiratory disease in the UK: part 2--regulatory activity by the Health and Safety Executive.
abstract: OBJECTIVE
  To investigate whether interventions implemented by the UK Health and Safety Executive addressing exposure to isocyanate-based spray paints in motor vehicle repair (MVR), flour dust in craft bakeries, rosin-based solder flux fume (RBSFF) in the electronics industry, metalworking fluids and wood dust coincided with a decline in incidence of work-related short latency respiratory disease (SLRD) or asthma in the target groups.
  
  
  METHODS
  Changes in the incidence of SLRD reported to a UK-based surveillance scheme were compared using a longitudinal, negative binomial regression model with β distributed random effects. An interrupted time series design was used and comparisons according to inclusion or exclusion in the target group were made by including a statistical interactions expressed as a ratio of incidence rate ratios (RIRRs) in the model.
  
  
  RESULTS
  The incidence of SLRD attributed to flour dust significantly increased relative to all other agents (RIRR: 1.10; 95% CI 1.06 to 1.16) whereas SLRD attributed to RBSFF significantly declined relative to all other agents (0.94; 0.90 to 0.99). No significant changes in the incidence of SLRD attributed to wood dust (1.03; 0.91 to 1.16) or spray paints (1.03; 0.95 to 1.11) relative to all other agents were observed. A higher proportion of reports originated from the industries targeted by the intervention for RBSFF (65/107; 61%) than spray painting (27/93; 27%) or wood dust (16/42; 38%).
  
  
  CONCLUSIONS
  These data support a beneficial effect of interventions to reduce exposure to RBSFF but an increase in SLRD attributed to flour dust may indicate increased exposure or increased awareness of the problem.
authors.affiliation: Centre for Epidemiology, Institute of Population Health, University of Manchester, Oxford Rd, Manchester, UK. jill.stocks@manchester.ac.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: Stocks
authors.forename: R
authors.initials: R
authors.lastname: McNamee
authors.forename: S
authors.initials: S
authors.lastname: Turner
authors.forename: M
authors.initials: M
authors.lastname: Carder
authors.forename: R M
authors.initials: RM
authors.lastname: Agius
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D059366:Asthma, Occupational / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004391:Dust; D005433:Flour / Q000633:toxicity; D006801:Humans; D015994:Incidence; D017953:Isocyanates / Q000633:toxicity; D008137:Longitudinal Studies; D015233:Models, Statistical; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012120:Respiration Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006113:United Kingdom / Q000453:epidemiology; D014934:Wood / Q000633:toxicity; D017967:Zinc Compounds / Q000633:toxicity
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D017953:Isocyanates; D017967:Zinc Compounds; C015510:soldering flux