Melanie Carder

Publications of Melanie Carder

• Work-related mental ill-health and 'stress' in the UK (2002-05).

  Authors: Melanie Carder, Susan Turner, Roseanne McNamee, Raymond Agius

  Occupational medicine (Oxford, England). 09/2009;

  BACKGROUND: There is concern about the frequency of work-related mental ill-health and 'stress' within the UK. AIMS: To provide a measure of the incidence of work-related mental ill-health reportedBACKGROUND: There is concern about the frequency of work-related mental ill-health and 'stress' within the UK. AIMS: To provide a measure of the incidence of work-related mental ill-health reported by specialist psychiatrists and occupational physicians to UK voluntary reporting schemes during the period 2002-05. Additionally, an investigation of determinants, notably factors identified by reporters as precipitants in cases of work-related mental ill-health was undertaken. METHODS: The study used data collected by The Health and Occupation Reporting Network (THOR) from 2002 to 2005. Cases were analysed by age, gender, industry and precipitating event. RESULTS: Estimated annual average incidence rates and 95% confidence intervals of work-related mental ill-health diagnoses reported to THOR between 2002 and 2005 by psychiatrists were 89 (78, 101) per million and by occupational physicians were 1589 (1443, 1735) per million. For both groups of reporters, anxiety and depression continued to make up the largest proportion of diagnoses. The majority of cases were attributed to factors such as workload and difficulties with other workers. There was some suggestion that the type of factors associated with the mental ill-health case reports varied between industrial sectors. CONCLUSIONS: Work-related anxiety and depression and stress continue to constitute a significant proportion of all work-related mental ill-health diagnoses in the UK, with workload and interpersonal relationships reported as significant risk factors. Further investigations may determine whether guidance for employers and employees on work-related mental ill-health would benefit from being more industry specific.

• Does socio-economic status modify the effect of particulate air pollution on cardiorespiratory mortality?

  Authors: Melanie Carder, Roseanne McNamee, Iain Beverland, Robert A Elton, Geoff Cohen, James Boyd, Martie van van Tongeren, Raymond M Agius

  Occupational and environmental medicine. 09/2009;

  OBJECTIVES: To investigate whether deprivation index modifies the acute effect of black smoke on cardiorespiratory mortality. METHODS: Generalised linear Poisson regression models were used toOBJECTIVES: To investigate whether deprivation index modifies the acute effect of black smoke on cardiorespiratory mortality. METHODS: Generalised linear Poisson regression models were used to investigate whether deprivation index (as measured by the Carstairs deprivation index) modified the acute effect of black smoke on mortality in the two largest Scottish cities (Glasgow and Edinburgh) between January 1981 and December 2001. Lag periods of up to one month were assumed for the effects of black smoke. RESULTS: Deprivation index significantly modified the effect of black smoke on mortality with black smoke effects generally increasing as level of deprivation increased. The interaction coefficient from a parametric model assuming a linear interaction between black smoke (microgm-3) and deprivation in their effect on mortality - equivalent to a test of 'linear trend' across Carstairs Categories - was significant for all mortality outcomes. In a model where black smoke effects were estimated independently for each deprivation category, the estimated increase in respiratory mortality over the ensuing one-month period associated with a 10microgm-3 increase in the mean black smoke concentration was 8.0 percent (95% CI: 5.1, 10.9) for subjects residing in the 'most' deprived category (Carstairs category 7) compared to 3.7 percent (95% CI: -0.7, 8.4) for subjects residing in the 'least' deprived category (Carstairs category 1). CONCLUSIONS: The results suggest a stronger effect of black smoke on mortality among people living in more deprived areas. The effect was greatest for respiratory mortality although significant trends were also seen for other groups. If corroborated, these findings could have important public health implications.

• Work-related musculoskeletal conditions: evidence from the THOR reporting system 2002-2005.

  Authors: Andy Slovak, Melanie Carder, Annemarie Money, Susan Turner, Raymond Agius

  Occupational medicine (Oxford, England). 07/2009;

  BACKGROUND: Musculoskeletal disorders (MSDs) are commonly encountered in current occupational health practice and comprise up to 45% of the workload for occupational physicians (OPs). AIMS: ToBACKGROUND: Musculoskeletal disorders (MSDs) are commonly encountered in current occupational health practice and comprise up to 45% of the workload for occupational physicians (OPs). AIMS: To compare the reported incidence of work-related (WR) MSDs by specialist OPs and specialist rheumatologists and to relate it to self-reported and general practitioners-reported WR MSDs. METHODS: Analysis of data reported to surveillance schemes within The Health and Occupation Reporting network and comparison to denominator data derived from the Labour Force Survey and occupational/work activity classifications. RESULTS: There are significant differences between the patterns of WR MSDs seen by the different specialist groups. Thus OPs report three times as many back and lower limb conditions. However, both specialist groups report similar numbers of cases of hand-arm vibration syndrome (12/9%) and 'vague and ill-defined' upper limb conditions (16/14%). The absolute risk of physician reported that WR MSDs increases 5-fold between ages 15-24 and 45-64. CONCLUSIONS: The specialist reporting schemes give an indication of current practice and are useful both to update and to strategically inform planning. The data are amenable, with appropriate statistical analysis, for comparison with self-reporting and to the characterization of risk in broad categories of occupation and work activity.

• Measurement of trends in incidence of work-related skin and respiratory diseases, UK 1996-2005.

  Authors: Roseanne McNamee, Melanie Carder, Yiqun Chen, Raymond Agius

  Occupational and environmental medicine. 05/2008;

  ABSTRACT OBJECTIVES: The ability to measure temporal trends in disease incidence is important but valid methods are needed. We investigated UK trends during 1996-2005 in work-related skin andABSTRACT OBJECTIVES: The ability to measure temporal trends in disease incidence is important but valid methods are needed. We investigated UK trends during 1996-2005 in work-related skin and respiratory diseases including non-malignant pleural disease, asthma, mesothelioma and pneumoconiosis and the potential for bias when using surveillance systems for this purpose. METHODS: The volunteer reporters in three surveillance schemes were specialist physicians for skin diseases, respiratory diseases and occupational physicians respectively, who provided monthly reports of new cases of disease which they considered work-related. Poisson regression models were used to investigate variation by calendar year (trend), season and reporter characteristics. Separately, temporal patterns in the probabilities of non-response and zero reports were investigated. Annual changes in disease incidences were compared between reporter groups. RESULTS: There was little evidence of change in incidences of non-malignant pleural disease, mesothelioma, skin neoplasia and urticaria but falls were seen for contact dermatitis and pneumoconiosis. Although the direction of changes were similar across reporter groups, the magnitude of annual change in incidence was often not consistent: for occupational asthma, it was -1.9% (95% CI: -5.2,1.4) and -12.1% (95% CI:-19.5,-4.1) using respiratory and occupational physician reports respectively. Response rates were high (~85%) but non-response increased slightly with membership time, as did the probability of a zero return in some groups. Adjustment of results for presumed reporting fatigue led to an upward correction in some calendar trends. CONCLUSIONS: Some estimated changes in incidence based on volunteer reporting may be biased by reporting fatigue; therefore apparent downward trends need to be interpreted cautiously. Differences in the population bases of the surveillance schemes and UK health service capacity constraints may also explain differences in trends found here. (277 words).