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Title: Mortality patterns among civilian workers in Royal Navy Dockyards
Author: Sullivan, Keith Richard
ISNI:       0000 0001 3489 4223
Awarding Body: London School of Hygiene & Tropical Medicine
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 1994
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This is a study of asbestos related disease in civilian workers at 3 Royal Naval Dockyards, namely: Devonport, Chatham and Portsmouth. Past work in these dockyards, along with Rosyth in Scotland (undertaken by the Institute of Naval Medicine and the Medical Research Council), has shown that just under 5% of this workforce might be expected to have radiographic abnormalities due to asbestos exposure. In the early 1970s workers in all 4 of these dockyards were invited to participate in health surveys, in which chest x-rays were performed and a health/employment history questionnaire given. This work is an exact 17 year follow-up of these health surveys, analysing cause specific mortality its time trends and their correlates. The working population of the 3 dockyards, including female industrial workers and ‘outstation’ male workers was 32,931. However, excluding female workers and absolute non-responders reduced this to 28,265 male workers. The trace rate of this population, over the 17 years, was 97.3% (Rosyth with a rate of less than 70% was excluded from this analysis), 18% of the population traced were found to be dead. The mortality patterns of this cohort were inspected on a yearly basis by the use of a regionally adjusted SMR analysis. Expected rates were calculated, using the OPCS historic mortality data files, to provide a reference set of background mortality levels. The striking result from this study is one of no excess risk due to lung cancer at the three dockyards, producing SMRs of: 99 (95%CI: 87-122) at Devonport, 85 (95%CI: 70-101) at Chatham, and 94 (95%CI: 81-106) at Portsmouth [X2=1.8, P > 0.1]. However, an excessive risk was seen for pleural mesothelioma that produced SMRs of: 1983 (95%CI: 1505-2461) at Devonport, 1638(95%CI: 1049-2437) at Chatham, and 1042 (95%CI: 693-1506) at Portsmouth [X2 = 8.4, P < 0.025]. Excesses were also seen for peritoneal mesothelioma and asbestosis. No obvious relationships were seen when analysing lung cancer mortality by employment and asbestos exposure variables. A dose-response of lung cancer mortality to smoking habit was the only clear relationship found. Log-linear modelling supported the SMR findings of no overall excess or deficiency of lung cancer mortality compared to an excess of mesothelioma deaths. These results and their significance are discussed.
Supervisor: Rossiter, C. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
Keywords: Asbestos exposure; Disease; Lung cancer