Occupational asthma as identified by the Surveillance of Work-related and Occupational Respiratory Diseases programme in South Africa

Background The nationwide Surveillance of Work-related and Occupational Respiratory Diseases in South Africa, SORDSA, was established in 1996 to prov;ide systematic information on occupational respiratory diseases. Objective SORDSA's objectives are to monitor the nature, extent and distribution bf occupational respiratory diseases, and to increase awareness of their diagnosis and prevention. This paper describes the programme and results obtained for occupational asthma in the first 2 years, ending in October 1998. Methods SORDSA identifies newly diagnosed cases of occupational respiratory disease through voluntary reporting by pulmonologists, occupational medicine doctors and occupational health nurses. Initially, recruitment of the above health care providers was done through the membership infrastructure of their respective professional societies. Booklets with prescribed monthly reporting forms were distributed annually to all reporting members and a core of reporting providers was established through a proactive method of data collection. Information dissemination and reporting feedback takes place through quarterly newsletters and issue-specific brochures on certain hazardous agents. Results Over the initial 2-year period, 3285 cases of occupational respiratory disease were reported to SORDSA by 203 doctors and 97 occupational health nurses. After pneumoconiosis and associated respiratory conditions, occupational asthma was the second most commonly reported disease with 225 cases (6.9%). The average annual incidence for occupational asthma in South Africa was 13.1 per million employed people, with the highest incidence reported from the Western Cape province (37.6 per million). Latex was the most frequently reported agent for occupational asthma, followed by isocyanates and platinum salts. Low molecular weight agents accounted for 59.6% of the cases of occupational asthma. Conclusion The results from this initial phase show that despite some limitations, SORDSA has the potential to obtain useful data on the industries, agents and occupations causing occupational asthma in South Africa.