Since February 1993 the EPIDERM surveillance scheme has collected data on occupational skin disease from consultant dermatologists in the UK. Reporting by occupational physicians to the scheme began in May 1994 and was superseded in January 1996 by the Occupational Physicians Reporting Activity (OPRA). The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in better targeting efforts to reduce the burden of skin disease at work.

The Occupational Physicians' Reporting Activity (OPRA) surveillance scheme for occupational physicians has now been in place for 4 years. During this period, an estimated 43,764 new cases of work-related disease have been reported. Musculoskeletal conditions make up nearly half (49%) of all cases; mental ill-health and skin disease account for 20% each, with respiratory conditions (8%) and hearing loss (5%) seen in lower proportions. Overall, eight of 42 diagnoses made up four-fifths of the new cases reported by occupational physicians. These were hand and arm disorders (8052 estimated cases), contact dermatitis (7104), disorders of the lumbar spine (6000), anxiety and depression (4788), work-related stress (3336), hearing loss (2100), elbow disorders (2040), and asthma (1680). Dermatitis and hearing loss were most frequent in manufacturing industries, lower back complaints in health care, and upper limb disorders in automotive manufacture. Psychiatric illnesses presented a different pattern, mainly affecting those in health, education and social service.

Consultant rheumatologists participate in surveillance of work-related musculoskeletal conditions under the Musculoskeletal Occupational Surveillance Scheme (MOSS), which has been in operation since 1997. During the first 3 years of the scheme, an estimated total of 8070 cases and 8442 diagnoses were obtained, an average of slightly less than 2700 estimated cases each year. Disorders of the upper limb accounted for approximately 66% (5502) of the total, with hand/wrist/arm conditions (3693 cases) comprising the majority of these. Conditions of the lumbar spine and trunk (13% of cases), the cervical spine (12%) and the shoulder (12%) were also frequently reported. Pain with ill-defined pathology was reported in 35% of cases with hand and forearm disorders. Overall, 82% of cases were related to repetitive rather than single injury. The largest numbers of cases were seen in workers in craft occupations (1659) and in clerical and secretarial workers (1524). High rates of musculoskeletal conditions, particularly of upper limb disorders, are notable in mining. In most occupations, and overall, women were at greater risk than men.

SummaryThe method of Kouklovsky and coworkers for the enantioselective alkylation of cyclic N-naphthoyl derivatives of amino acids was used to introduce a 13C label into one of the two enantiotopic methyl groups of 2-aminoisobutyric acid (Aib) by retentive alkylation of L-alanine with 13CH3I. Conditions were identified for optimization of yield and enantiomeric purity, and the absolute configuration of the labelled product was established.

The SWORD surveillance scheme, now 10 years old, uses systematic reporting from physicians to provide a picture of the incidence of occupational respiratory disease in the United Kingdom. An estimated total of 2966 incident cases was derived from reports by chest and occupational physicians during the 1998 calendar year. Occupational asthma continues to be the most-reported respiratory condition, with an estimated 822 cases (27% of total cases). The proportion of cases of mesothelioma (23%), benign pleural disease (21%) pneumoconiosis (7%) and inhalation injuries (6%) remain similar to those estimated in past years, although fewer cases overall were reported. The most commonly identified agents causing asthma in 1998 were enzymes, isocyanates, laboratory animals and insects, colophony and fluxes, flour, latex, and glutaraldehyde. An increased incidence of respiratory diseases of short latency was seen in mining, whilst cases in chemical, mineral products and motor vehicle manufacture remained high; lower rates were noted in wood products and textile manufacture when compared with 1997 figures. Inhalation accidents over the past 3 years were reviewed; gaseous agents and combustion products accounted for nearly half of cases. High rates for inhalation injuries were seen in coal miners, fuel production, motor vehicle manufacturing, water purification, and chemical manufacturing.