L Rushton

Publications of L Rushton

• Should protocols for observational research be registered?

  Authors: L Rushton

  Occupational and environmental medicine. 02/2011; 68(2):84-6.

• Occupation and cancer in Britain.

  Authors: L Rushton, S Bagga, R Bevan, T P Brown, J W Cherrie, P Holmes, L Fortunato, R Slack, M Van Tongeren, C Young, S J Hutchings

  British journal of cancer. 04/2010; 102(9):1428-37.

  Prioritising control measures for occupationally related cancers should be evidence based. We estimated the current burden of cancer in Britain attributable to past occupational exposures forPrioritising control measures for occupationally related cancers should be evidence based. We estimated the current burden of cancer in Britain attributable to past occupational exposures for International Agency for Research on Cancer (IARC) group 1 (established) and 2A (probable) carcinogens. We calculated attributable fractions and numbers for cancer mortality and incidence using risk estimates from the literature and national data sources to estimate proportions exposed. 5.3% (8019) cancer deaths were attributable to occupation in 2005 (men, 8.2% (6362); women, 2.3% (1657)). Attributable incidence estimates are 13 679 (4.0%) cancer registrations (men, 10 063 (5.7%); women, 3616 (2.2%)). Occupational attributable fractions are over 2% for mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma, larynx and stomach cancers. Asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists each contribute 100 or more registrations. Industries and occupations with high cancer registrations include construction, metal working, personal and household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors. 56% of cancer registrations in men are attributable to work in the construction industry (mainly mesotheliomas, lung, stomach, bladder and non-melanoma skin cancers) and 54% of cancer registrations in women are attributable to shift work (breast cancer). This project is the first to quantify in detail the burden of cancer and mortality due to occupation specifically for Britain. It highlights the impact of occupational exposures, together with the occupational circumstances and industrial areas where exposures to carcinogenic agents occurred in the past, on population cancer morbidity and mortality; this can be compared with the impact of other causes of cancer. Risk reduction strategies should focus on those workplaces where such exposures are still occurring.

• Occupation and cancer in Britain

  Authors: L Rushton, S Bagga, R Bevan, T P Brown, J W Cherrie, P Holmes, L Fortunato, R Slack, M Van Tongeren, C Young, S J Hutchings

  British Journal of Cancer. 01/2010; 102:1428-1437.

  British Journal of Cancer 102, 1428 (2010). doi:10.1038/sj.bjc.6605637

• How much does benzene contribute to the overall burden of cancer due to occupation?

  Authors: L Rushton, T P Brown, J Cherrie, L Fortunato, M van Tongeren, S J Hutchings

  Chemico-biological interactions. 11/2009;

• Systematic review and meta-analysis of mortality in crop protection product manufacturing workers.

  Authors: D R Jones, A J Sutton, K R Abrams, J Fenty, F Warren, L Rushton

  Occupational and environmental medicine. 02/2009; 66(1):7-15.

  OBJECTIVES: The potential health effects of the manufacture and use of crop protection chemicals were investigated through systematic review and meta-analysis of studies of cohorts of workers in theOBJECTIVES: The potential health effects of the manufacture and use of crop protection chemicals were investigated through systematic review and meta-analysis of studies of cohorts of workers in the crop protection product manufacturing industry. METHODS: Several computerised literature databases were searched from inception until December 2003, with references listed in identified articles checked for further relevant articles. Random effects meta-analyses of log standardised mortality ratios (SMRs) were carried out. Heterogeneity was explored through subgroup analyses and meta-regression; sensitivity analyses of different approaches for zero events were performed. RESULTS: 21 references reporting information on 37 separate cohorts for mortality were identified. The meta-SMR for all cause mortality was 0.94 (95% CI 0.88 to 1.00) (37 cohorts). Significantly raised mortality was found for cancers of the buccal cavity and pharynx, oesophagus, rectum, larynx, lung, and lymphatic and haematopoietic system with little heterogeneity being observed. Excluding studies with zero events identified additional excesses. CONCLUSIONS: Evidence of multiple excesses, particularly in subgroups exposed to phenoxy herbicides contaminated with dioxins, substantiates previous findings. The importance of careful treatment of zero cases was highlighted. Future systematic reviews and meta-analyses would benefit from availability of results for a standard list of causes of disease.

• The precautionary principle in the context of multiple risks.

  Authors: L Rushton

  Occupational and environmental medicine. 10/2007; 64(9):574.

• Organic dusts and respiratory cancer: a complex issue.

  Authors: L Rushton

  Occupational and environmental medicine. 12/2006; 63(11):717.

• Meta-analysis of mortality and cancer incidence among workers in the synthetic rubber-producing industry.

  Authors: N Alder, J Fenty, F Warren, A J Sutton, L Rushton, D R Jones, K R Abrams

  American journal of epidemiology. 10/2006; 164(5):405-20.

  Production of synthetic rubber involves exposure to several potentially harmful chemicals. The authors carried out a systematic review and meta-analysis of cohort studies of workers in theProduction of synthetic rubber involves exposure to several potentially harmful chemicals. The authors carried out a systematic review and meta-analysis of cohort studies of workers in the rubber-producing industry. Data were obtained from computerized literature searches of several databases from their inception through December 2003. The reference lists of identified articles were inspected for further relevant articles. The authors conducted random-effects meta-analyses of log standardized mortality ratios (SMRs)/standardized incidence ratios. Heterogeneity between study results was explored through subgroup analyses and meta-regression on cohort demographic factors and study quality indicators. The authors identified 36 published articles reporting information on 31 different cohort groups. The meta-SMR was 0.86 (95% confidence interval (CI): 0.82, 0.91) for all-cause mortality (28 cohorts) and 0.94 (95% CI: 0.89, 1.01) for all malignant neoplasms (27 cohorts). Heterogeneity was observed for these endpoints and for the majority of disease-specific outcomes. Statistically significant excesses were observed for diabetes (meta-SMR=1.36, 95% CI: 1.17, 1.59) (five cohorts) and leukemia (meta-SMR=1.21, 95% CI: 1.03, 1.43) (16 cohorts), the latter particularly for persons working exclusively in nontire manufacturing (meta-SMR=1.70, 95% CI: 1.14, 2.54) (four cohorts). Excesses highlighted in previous narrative reviews were not substantiated. Interpretation of these results is complicated by substantial unexplainable heterogeneity; small excesses in specific mortality outcomes may have been disguised by the healthy worker effect.

• Intervention development in occupational research: an example from the printing industry.

  Authors: T P Brown, L Rushton, H C Williams, J S C English

  Occupational and environmental medicine. 05/2006; 63(4):261-6.

  BACKGROUND: Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness.BACKGROUND: Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness. METHODS: Focus groups (n = 5) and direct observational studies (n = 21) of printers were used to elicit key issues that would aid the development of subsequent interventions. Transcripts from these were analysed by standard qualitative methods to identify common and related themes. RESULTS: The views of managers differed significantly from those of print workers in a number of areas, and working practices did not always follow policy. The majority of printers did not perceive dermatitis to be a major problem, although many complained of dry hands. Other key results included: the lack of skin care policy in most companies; poor understanding of the nature, causes, and treatment of dermatitis; low priority of dermatitis within health and safety concerns; little or no provision of occupational health services, particularly skin checks; variability in provision of and access to appropriate skin protection; and lack of accessible washing facilities. CONCLUSIONS: As a result it was decided to evaluate the implementation of four INTERVENTIONS: provision of (1) skin checks and treatment advice; (2) gloves of the correct type and size, and use of an after-work cream; (3) information on dermatitis within the printing industry; and (4) development of best practice skin care policy.

• Locally generated particulate pollution and respiratory symptoms in young children.

  Authors: N. Pierse, L Rushton, R.S. Harris, C E Kuehni, M Silverman, J Grigg

  Thorax. 03/2006; 61(3):216-20.

  BACKGROUND: Particulate matter <10 mum (PM(10)) from fossil fuel combustion is associated with an increased prevalence of respiratory symptoms in children and adolescents. However, the effect ofBACKGROUND: Particulate matter <10 mum (PM(10)) from fossil fuel combustion is associated with an increased prevalence of respiratory symptoms in children and adolescents. However, the effect of PM(10) on respiratory symptoms in young children is unclear. METHODS: The association between primary PM(10) (particles directly emitted from local sources) and the prevalence and incidence of respiratory symptoms was studied in a random sample cohort of 4400 Leicestershire children aged 1-5 years surveyed in 1998 and again in 2001. Annual exposure to primary PM(10) was calculated for the home address using the Airviro dispersion model and adjusted odds ratios (ORS) and 95% confidence intervals were calculated for each microg/m(3) increase. RESULTS: Exposure to primary PM(10) was associated with the prevalence of cough without a cold in both 1998 and 2001, with adjusted ORs of 1.21 (1.07 to 1.38) and 1.56 (1.32 to 1.84) respectively. For night time cough the ORs were 1.06 (0.94 to 1.19) and 1.25 (1.06 to 1.47), and for current wheeze 0.99 (0.88 to 1.12) and 1.28 (1.04 to 1.58), respectively. There was also an association between primary PM(10) and new onset symptoms. The ORs for incident symptoms were 1.62 (1.31 to 2.00) for cough without a cold and 1.42 (1.02 to 1.97) for wheeze. CONCLUSION: In young children there was a consistent association between locally generated primary PM(10) and the prevalence and incidence of cough without a cold and the incidence of wheeze which was independent of potential confounders.

• Mortality in the UK industrial silica sand industry: 1. Assessment of exposure to respirable crystalline silica.

  Authors: T P Brown, L Rushton

  Occupational and environmental medicine. 08/2005; 62(7):442-5.

  AIMS: To develop a job-exposure matrix (JEM) from personal and static respirable crystalline silica (RCS) measurements in UK industrial silica sand workers. METHODS: A total of 2429 personal and 583AIMS: To develop a job-exposure matrix (JEM) from personal and static respirable crystalline silica (RCS) measurements in UK industrial silica sand workers. METHODS: A total of 2429 personal and 583 static RCS dust samples were collected using cyclone samplers at seven UK quarries between 1978 and 2000. These data were combined, and analysis of variance using general linear models was used to evaluate the effect of quarry, job, and year on RCS concentrations, and facilitate the creation of five quarry and three time categories with similar exposure levels by comparing the least-square GM RCS concentrations. RESULTS: The overall geometric mean (GM) RCS concentration was 0.09 mg/m3 (geometric standard deviation 3.9). Silica flour and dry job categories tended to have the highest RCS exposure and 13.3% of all samples exceeded the UK maximum exposure level of 0.3 mg/m3. RCS levels generally decreased over time. CONCLUSIONS: Data have been collected and used to develop a JEM for UK industrial silica sand workers between 1978 and 2000. Although there were some limitations in the data and certain assumptions were made, the use of available data to estimate exposure quantitatively is an improvement over the use of qualitative and surrogate measures of exposure. The continual collection of dust measurements in the industry is essential to facilitate the exploration of exposure-response relations that may exist between silica and silicosis, lung cancer, and other diseases.

• Mortality in the UK industrial silica sand industry: 2. A retrospective cohort study.

  Authors: T P Brown, L Rushton

  Occupational and environmental medicine. 08/2005; 62(7):446-52.

  AIMS: To evaluate the mortality experience of a cohort of employees in the UK silica sand industry exposed to respirable crystalline silica (RCS). METHODS: A retrospective cohort mortality studyAIMS: To evaluate the mortality experience of a cohort of employees in the UK silica sand industry exposed to respirable crystalline silica (RCS). METHODS: A retrospective cohort mortality study followed all workers to 2001 with at least one year's employment at one of seven UK silica sand producing quarries between 1950 and 1986. Each worker was assigned a job category and cumulative exposure to RCS was estimated using a job-exposure matrix. RESULTS: A total of 764 deaths were identified in 2703 cohort members. The overall mortality rate for the cohort was lower than would be expected in the general population. Mortality from circulatory and respiratory disease was also less than expected, but death due to pneumoconiosis was slightly raised (two deaths). Mortality from all cancers was slightly decreased. Mortality was not raised in any job category. Cancer mortality was raised at one quarry due to a significant increase in lung (standardised mortality rate (SMR) 162.0, 95% CI 113.5 to 224.3) and bladder (SMR 366.5, 95% CI 167.6 to 695.7) cancers. Mortality from lung cancer and other causes did not show a trend with cumulative exposure to RCS. CONCLUSIONS: This study did not show any consistent relation between RCS exposure (in the absence of other known carcinogens) and the development of lung cancer. This contrasts with a number of studies that have shown positive findings in similar and related industries.

• Estimation of the impact on children's health of environmental tobacco smoke in England and Wales.

  Authors: L Rushton, C Courage, E Green

  Journal of the Royal Society of Health. 10/2003; 123(3):175-80.

  In this paper, the population attributable risk (PAR), a measure of the excess risk of disease associated with a risk factor, is calculated for some of the common adverse health effects that haveIn this paper, the population attributable risk (PAR), a measure of the excess risk of disease associated with a risk factor, is calculated for some of the common adverse health effects that have been associated with exposure of children to environmental tobacco smoke (ETS): childhood lower respiratory illness, chronic middle ear disease, asthma and sudden infant death syndrome (SIDS). Published data on both risk estimates and the percentage of children exposed to ETS in the home (prevalence of ETS) have been utilised. The percentage of childhood lower respiratory illness and middle ear disease typically attributable to ETS from either parent smoking ranged from 9% for asthma prevalence and for referral for glue ear, to 25% for hospital admission for lower respiratory illness. Where data were available to calculate PARs separately for mother only smoking and father only smoking, the PARs were generally larger for mothers only smoking, due mainly to higher odds ratios for mothers only smoking. The PAR for SIDS attributable to ETS from mother only smoking was 11%. Although based on a small number of studies, the PAR for SIDS attributable to smoking of fathers only was similar to that attributable to the smoking of mothers only, largely due to the higher prevalence of households where only the father smokes. This study has shown that the impact of ETS on childhood illness can be considerable, emphasising the importance of the need to develop effective strategies for reducing the risk of ETS exposure in the home and elsewhere.

• Reducing domestic exposure to environmental tobacco smoke: a review of attitudes and behaviours.

  Authors: E Green, C Courage, L Rushton

  Journal of the Royal Society of Health. 04/2003; 123(1):46-51.

  This paper reviews research on attitudes and behaviours towards environmental tobacco smoke (ETS), with a special focus on child health and the indoor environment. Research needs and ways forward toThis paper reviews research on attitudes and behaviours towards environmental tobacco smoke (ETS), with a special focus on child health and the indoor environment. Research needs and ways forward to encourage reductions in domestic ETS levels are discussed. Published material was identified through online literature searches (Medline, Toxline, Cancerlit, Biosis, Embase, Enviroline, Sociological Abstracts, Social Science Citation Index, Academic Index and Psychinfo). The literature search strategy employed search terms such as "passive smoking" or "environmental tobacco smoke" with "attitude" or "awareness" and other synonyms. Additional publications were identified by citation chasing and expert advice. Focusing on the UK, studies that provided survey-derived data about attitudes and behaviours in relation to ETS exposure in the indoor environment were selected for review. Published studies from other countries were also included when they provided information pertinent to this review. Most people are aware of the health risks associated with ETS exposure, and there is a high level of support for smoking restrictions in public places to protect non-smokers from ETS. However, although there is concern among both non-smoking and smoking parents about children and second-hand smoke, many people allow children to be exposed to ETS in the home. The review suggests that traditional health promotion campaigns have had only limited success in encouraging ETS risk reduction measures in the home. Because ETS is a public health priority, particularly in relation to child health, the barriers to the uptake of such measures need to be explored in detail to inform the future promotion of reductions in domestic levels of ETS.

• The prevalence of occupational dermatitis in the UK printing industry.

  Authors: E J Livesley, L Rushton, J S English, H C Williams

  Occupational and environmental medicine. 08/2002; 59(7):487-92.

  AIMS: To quantify occupational ill health resulting from dermatitis in the UK printing industry and to explore links with particular processes and activities. METHODS: Approximately 2600 members ofAIMS: To quantify occupational ill health resulting from dermatitis in the UK printing industry and to explore links with particular processes and activities. METHODS: Approximately 2600 members of the Graphical, Paper and Media Union living in Nottinghamshire were sent a self completion questionnaire. A sample of respondents, both those who reported current skin problems and those who did not, were invited for a short dermatological examination. RESULTS: The overall response rate was 62%. A total of 1189 respondents were directly involved in the printing industry and categorised according to work in pre-press (25%), printing (46%), or finishing (42%) processes. A total of 490 respondents (41%) self reported having a skin complaint at some time. Prevalence was highest in males (43%) and those working in printing (49%), in particular those who cleaned rollers and cylinders or who came into contact with substances containing isocyanates on a daily basis. The most commonly affected areas reported were the fingers and webs between the fingers. Twenty six per cent of the 490 reported a current problem on the hand. Reported symptoms included itching (61%), rash (58%), and dry skin (56%). Although certain printing industry substances were thought by respondents to aggravate their condition, constant washing and friction was most often cited. Reported use of protective equipment and cleansing products was generally high, particularly by printers. Clinical examination confirmed the high self reported prevalence and also identified a substantial proportion of mild cases which were not reported. The overall prevalence of occupationally related skin complaints is estimated to be 40%. CONCLUSIONS: A much higher prevalence of dermatitis has been identified than from routine surveillance schemes. The use of good quality records from unions with high membership facilitated access to workers across a range of company sites and printing processes. Validation of self reported symptoms through clinical examination was shown to be essential. The importance of non-chemical causes of dermatitis was highlighted. The findings point towards the need for the development of effective and acceptable risk reduction strategies, in particular to reduce water contact and friction.

• Clinical examinations to validate self-completion questionnaires: dermatitis in the UK printing industry.

  Authors: E J Livesley, L Rushton, J S C English, H C Williams

  Contact dermatitis. 08/2002; 47(1):7-13.

  A self-completion questionnaire sent to 2600 Nottinghamshire members of the Graphical Paper and Media Union elicited a 62% response. Forty one per cent of respondents reported suffering a skinA self-completion questionnaire sent to 2600 Nottinghamshire members of the Graphical Paper and Media Union elicited a 62% response. Forty one per cent of respondents reported suffering a skin complaint at some time and 11% had a current skin problem on the hand. This paper reports the validation stage of the study. Samples of 45 'cases' of self-reported dermatitis and 60 'controls', who reported they had never suffered a skin complaint, were clinically examined. All 45 self-reported cases were clinically confirmed as dermatitis. Occupationally related irritant contact dermatitis (ICD) was diagnosed in 20 (44%); 26 (58%) complaints were thought to be induced or exacerbated by occupation. Of the controls, 21 (35%) were also diagnosed with a skin complaint, the majority being mild, with an occupational association in 17, the majority (15) being ICD. Sixteen ICD cases were patch tested resulting in positive reactions to colophony, neomycin, nickel and potassium dichromate (2 of each). Two cases of basal cell carcinoma on the face were also identified, of which the participants were unaware. Although there was no false positive self-reporting there was a considerable number of false negatives, demonstrating the importance of clinical validation of questionnaires relating to industrial skin disease. This study has highlighted the need for improvement in skin care provision in the printing industry.

• Impact of private funding on access to elective hospital treatment in the regions of England and Wales. National records survey.

  Authors: B Williams, P Whatmough, J McGill, L Rushton

  European journal of public health. 01/2002; 11(4):402-6.

  BACKGROUND: The UK National Health Service aims to match access to health care to the level of need and to reduce inequalities in the health of sub-populations. One in ten persons have privateBACKGROUND: The UK National Health Service aims to match access to health care to the level of need and to reduce inequalities in the health of sub-populations. One in ten persons have private medical insurance (PMI). This study describes the impact of private purchasing on access to hospital care in regions according to health need. METHOD: Details of admissions to NHS hospitals in one year and waiting times were obtained from the government's Hospital Episodes Statistics, and of patients in independent hospitals through weighted time samples of records. Data were combined into two groups, state funded and privately funded patients. The prevalence of limiting longstanding illness and the proportions of individuals covered by PMI in Wales and the eight English health regions were obtained from the General Household Survey. Correlation coefficients were calculated for inter-regional relationships between measures of need, provision of resources and levels of activity. RESULTS: Limiting, longstanding illness was significantly associated with NHS resource levels, NHS hospital activity, and total hospital activity, however funded; and inversely with PMI coverage, waiting times for NHS admission and levels of privately funded activity. Waiting times for admission were positively correlated with PMI coverage. CONCLUSIONS: Regionally, NHS resources and activity match need. Private hospital use complements lower levels of NHS service. Private consumption does not distort access according to need but in regions with lower levels of NHS activity those least deprived may make relatively more use of NHS hospitals, thus widening the health gap. Small area studies should explore this.

• Assessing exposures in the United Kingdom's Armed Forces--a review of systems that collect data useful for exposure assessment.

  Authors: A C Capleton, S D Short, L Rushton

  Journal of the Royal Army Medical Corps. 11/2001; 147(3):301-8.

  The ability to assess the exposure of individuals or groups is a critical element in any effective health surveillance system, as it provides the opportunity to identify the causes of ill health, theThe ability to assess the exposure of individuals or groups is a critical element in any effective health surveillance system, as it provides the opportunity to identify the causes of ill health, the levels of exposure resulting in ill health and, through controlling exposures, to protect the health of Service personnel. As part of a wider programme to enhance the health surveillance capabilities of the Defence Medical Services, a project was undertaken to assess the collection and retention of data for exposure assessment in the United Kingdom's Armed Forces. The systems investigated include those for health, safety and environment policy, personnel and pay, medical records, environmental and occupational monitoring and historical records. It was found that the use of many systems for exposure assessment would be hampered by inconsistencies in the data collected, poor accessibility and linkage, and variability in the retention of the data. This paper highlights some of the problems that limit the usefulness of the record systems for exposure assessment and summarizes the principal recommendations made for enhancing the systems to better facilitate health surveillance.

• The possible effects on health, comfort and safety of aircraft cabin environments.

  Authors: T P Brown, L K Shuker, L Rushton, F Warren, J Stevens

  Journal of the Royal Society of Health. 10/2001; 121(3):177-84.

  A consultation was undertaken to investigate the views and concerns of stakeholders in the aircraft industry about the possible harmful effects on personal health, comfort and safety of aircraftA consultation was undertaken to investigate the views and concerns of stakeholders in the aircraft industry about the possible harmful effects on personal health, comfort and safety of aircraft cabin environments. Stakeholders were identified from a variety of sources including Government agencies, the Internet, House of Lords inquiry, and suggestions of interviewees. They represented: aircraft crews, aircraft constructors and engineers, government departments and authorities, holiday/flight companies, insurance companies, non-governmental organisations, occupational health physicians, passenger representatives, and independent researchers and consultants. Eighty-seven were contacted of which 57 were interviewed over the telephone using a semi-structured questionnaire. Their concerns were transcribed into a standard format and analysed qualitatively. Key stakeholders, along with Government officials, were invited to a workshop to discuss and prioritize the issues raised during the interviews. The main concerns expressed by the participants fell into five main areas: deep vein thrombosis, air quality, infection, cosmic radiation, and jet lag and work patterns. In addition, a number of safety concerns were raised as well as comments on the provision of appropriate advice to passengers. It was generally felt that further research was required on each of these subjects, as well as an improvement in the quality, quantity and availability of information provided for passengers prior to boarding a flight.

• Exposure information in European industry: implications for future occupational research.

  Authors: L Rushton, D S Betts

  Applied occupational and environmental hygiene. 03/2001; 16(2):178-81.

  A survey has been carried out among European industry to investigate the collection and retention of records which might be used for epidemiological research. Exposure information results areA survey has been carried out among European industry to investigate the collection and retention of records which might be used for epidemiological research. Exposure information results are reported. Approximately 1,000 questionnaires focusing on exposure information were sent to seven countries, with a 42 percent response rate. Eighty-two percent of companies reported that exposure measurements were taken to comply with legal requirements. Measurements were most often made for noise (84%), with 48% of companies measuring chemicals, 48 percent particulates but only 10 percent vibration. Measurements were most often taken for specific locations (73%), rather than for particular jobs (54%) or individual workers (50%). Eighty percent recorded location, sampling date, agents measured, and units of measurement, with about 70 percent recording job being sampled, sampling method, and duration and plant process, but less than 60 percent recording environmental conditions or worker details. Overall, only 10 percent of companies kept their exposure information forever, and 71 percent kept it for 10 years or less. Legislative requirements were most often cited as the reason for retention of records. The variation in the quantity and quality of measurements and the early destruction of records poses considerable problems for European research. Inaccuracy and misclassification of exposure limits the ability to establish causal relationships between effect and disease. Records should uniquely identify an individual worker and facilitate linkage to exposure and health effects information. Their format should be accessible, linkable, and secure. Data should be kept by an identifiable organization and there should be a secure chain of custody if a company goes out of business. Unless industry can be motivated to follow these guidelines the future of research into occupational causes of ill health, and in particular, the evaluation of exposure, will be limited.