Occupational Mortality Matrix: A Tool for Epidemiological Assessment of Work-Related Risk Based on Current Data Sources

Our plain-English summary of Occupational Mortality Matrix: A Tool for Epidemiological Assessment of Work-Related Risk Based on Current Data Sources, by S. Massari, V.C. Malpassuti, A. Binazzi, et al (International Journal of Environmental Research and Public Health, 2022).

The study

• Authors: S. Massari, V.C. Malpassuti, A. Binazzi, L. Paris, C. Gariazzo, A. Marinaccio
• Journal: International Journal of Environmental Research and Public Health
• Published: 2022;19(9)
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mortality from occupational diseases significantly afflicts society, in terms of both economic costs and human suffering. The International Labour Organization (ILO) estimated that 2.4 million workers die from work-related diseases every year. In Europe, around 80,000 workers die from cancer attributed to occupational exposure to carcinogens. This study developed the Occupational Mortality Matrix (OMM) aimed to identify significant associations between causes of death and occupational sectors through an individual record linkage between mortality data and the administrative archive of occupational histories. The study population consisted of 6,433,492 deceased subjects in Italy (in the period 2005-2015), of which 2,723,152 records of work histories were retrieved (42%). The proportional mortality ratio (PMR) was estimated to investigate the excess of mortality for specific causes associated with occupational sectors. Higher PMRs were reported for traditionally risky occupations such as shipbuilding for mesothelioma cases (PMR: 8.15; 95% CI: 7.28-9.13) and leather production for sino-nasal cancer (PMR: 5.04; 95% CI: 3.54-7.19), as well as for unexpected risks such as male breast cancer in the pharmaceutical industry (PMR: 2.56; 95% CI: 1.33-4.93) and brain cancer in railways (PMR: 1.43; 95% CI: 1.24-1.66). The OMM proved to be a valid tool for research studies to generate hypotheses about the occupational etiology of diseases, and to monitor and support priority actions for risk reduction in workplaces.

In plain English

This study linked Italian death records with social security work histories to build an Occupational Mortality Matrix. Of 6,433,492 people who died in Italy in 2005 to 2015, 2,723,152 (42%) had linked private-company work histories; most (82%) were retired. For each industry and cause of death, the authors calculated proportional mortality ratios (PMRs). A PMR compares one cause's share of deaths in one industry with its share in all other industries, adjusted for age and education. Exposure was represented only by industry and length of employment. Exposure intensity and job title were unavailable; asbestos was not measured. Among men who worked in shipbuilding, the PMR was 8.15 (95% CI 7.28 to 9.13) for mesothelioma and 27.07 (20.34 to 36.04) for asbestosis. For asbestosis among men in concrete, cement and plaster manufacture it was 8.11 (6.13 to 10.71). Among women in textile manufacture, the PMR for mesothelioma was 2.20 (1.86 to 2.60). Risks generally rose with longer employment. The authors concluded that the matrix is a valid tool for generating hypotheses. They noted that it could not account for smoking.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Proportional mortality study using individual record linkage between national cause-of-death data and social security (INPS) employment records
• Who was studied: 6,433,492 people aged over 20 who died in Italy in 2005 to 2015. Work histories were retrieved for 2,723,152 (42%; 57% of males, 29% of females). The records cover people who worked for private companies, about 55% of the Italian workforce. Public employees and the self-employed are not included. The linked group had an average age of 76, and 82% were retired from work.
• Exposure: Economic sector of employment (NACE Rev. 2 categories) from 1974 onwards, at least 1 year, and duration of employment. No specific fibers, products, job titles or exposure levels were recorded. The authors describe mesothelioma and asbestosis as asbestos-related diseases.
• Main results:
  • Males employed in building of ships and boats: 289 mesothelioma deaths, PMR 8.15 (95% CI 7.28 to 9.13). For employment of more than 10 years: 219 deaths, PMR 8.62 (7.57 to 9.82).
  • Males employed in building of ships and boats: 48 asbestosis deaths, PMR 27.07 (95% CI 20.34 to 36.04).
  • Males employed in manufacture of concrete articles, cement and plaster: 51 asbestosis deaths, PMR 8.11 (95% CI 6.13 to 10.71).
  • Males, mesothelioma: railways had 131 deaths, PMR 3.04 (95% CI 2.53 to 3.56). Water transport had 120 deaths, PMR 3.27 (2.73 to 3.9).
  • Females employed in manufacture of textiles: 136 mesothelioma deaths, PMR 2.20 (95% CI 1.86 to 2.60).
  • Males employed in manufacture of leather and related products: 31 sino-nasal cancer deaths, PMR 5.04 (95% CI 3.54 to 7.19).
  • Risks increased with duration of employment for almost all causes of death, especially typical occupational diseases such as mesothelioma.
  • Unexpected associations were found for male breast cancer in the pharmaceutical industry, PMR 2.56 (95% CI 1.33 to 4.93). Brain cancer among male railway workers had a PMR of 1.43 (1.24 to 1.66).
• The authors' conclusion: The authors concluded that the Occupational Mortality Matrix is a valid tool for generating hypotheses about occupational causes of disease and for supporting priority prevention actions in workplaces.
• Limitations the authors state:
  • The administrative records give only the industrial sector, not job title or exposure intensity.
  • Confounding factors such as smoking, diet and socioeconomic status may not have been accounted for.
  • Because the method uses deaths, diseases with low lethality are not highlighted, and the results reflect past, not current, exposure situations.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Occupational Disease, Occupational Exposure, Proportional mortality, Mesothelioma, Etiology.

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