Raymond Martin Agius

Raymond Martin Agius
The University of Manchester · Centre for Epidemology, Institute of Population Health

Doctor of Medicine

About

334
Publications
33,160
Reads
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6,662
Citations
Introduction
Current research interests include: Occupational Health aspects of the covid-19 pandemic especially prevention and investigation of disease and death.
Additional affiliations
March 2001 - present
The University of Manchester
Position
  • Lead: Centre for Epidemiology; Director: Centre for Occupational & Environmental Health
March 2001 - present
Central Manchester University Hospitals NHS Foundation Trust
Position
  • Honorary Consultant in Occupational Medicine
October 1990 - March 2001
The University of Edinburgh
Position
  • Senior Lecturer in Occupational & Environmental Health

Publications

Publications (334)
Article
The more I think about it, the more I feel that the answer to this question dates back to way before I knew what ‘occupational medicine’ meant. At school, I enjoyed and excelled in the sciences, especially chemistry and physics. I set up a laboratory in the basement at home and used to carry out experiments with chemicals I bought from pharmacies o...
Article
Full-text available
Objectives This study aims to develop a comprehensive list of stressors relevant to junior doctors and will also report findings exploring the associations between burnout and stressors, which include work and non-work–related stressors as well as pandemic-related stressors. Methods An anonymous online questionnaire was sent to 1000 randomly selec...
Article
Full-text available
In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of socia...
Article
Full-text available
Background: Air pollution has been consistently linked with dementia and cognitive decline. However, it is unclear whether risk is accumulated through long-term exposure or whether there are sensitive/critical periods. A key barrier to clarifying this relationship is the dearth of historical air pollution data. Objective: To demonstrate the feas...
Preprint
Full-text available
Background Air pollution has been consistently linked with dementia and cognitive decline. However, it is unclear whether risk is accumulated through long-term exposure or whether there are sensitive/critical periods. A key barrier to clarifying this relationship is the dearth of historical air pollution data. Objective To demonstrate the feasibil...
Article
Background: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations. Aims: This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work. Methods: Covid-19 guidance from the chief coroner a...
Article
Epidemiological studies have suggested a link between low-level radiation exposure and an increased risk of cardiovascular disease, but the possibility of bias or confounding must be considered. We analyzed data from a matched case-control study nested in a cohort of British male industrial (i.e., blue-collar) nuclear fuel cycle workers using paire...
Article
Full-text available
Importance Evidence suggests that physicians experience high levels of burnout and stress and that trainee physicians are a particularly high-risk group. Multiple workplace- and non–workplace-related factors have been identified in trainee physicians, but it is unclear which factors are most important in association with burnout and stress. Better...
Chapter
Why I became an occupational physician … briefly explores the reasons and influences behind Raymond Agius’s decision to pursue a career in occupational medicine. It takes us through his early days experimenting with chemicals in his parent’s basement, interest in the causes of disease while at medical school, and eventual move to the Institute of O...
Article
Full-text available
Objectives: The processing of seafood (fish and shellfish) for human consumption can lead to health consequences, including occupational asthma (OA). Several non-UK studies have reported both respiratory outcomes and airborne levels of major allergens in seafood processing. However, there is a paucity of such evidence in the UK land-based seafood...
Chapter
Occupational diseases are those for which work or, specifically, exposures in the workplace are necessary causes. The most prevalent occupational diseases in developed countries today are musculoskeletal and psychological disorders (usually stress-related conditions), but generally occupationally related malignancies (e.g. mesothelioma related to a...
Article
Objectives To examine associations between occupational exposures to rubber dust, rubber fumes and N-nitrosamines and non-cancer mortality. Methods A cohort of 36 441 males aged 35+ years employed in British rubber factories was followed-up to 2015 (94% deceased). Competing risk survival analysis was used to assess risks of dying from non-cancer d...
Article
Background: The world of work is continually changing, and this could result in new and emerging risks being introduced, including those that may cause work-related respiratory diseases (WRRD). Aims: To describe recently emerging and new cases of WRRD and the relevant methodology using data in a national occupational respiratory disease surveill...
Article
Objectives Evidence suggests United Kingdom trainee doctors are experiencing high levels of stress; however, little is known about what determinants contribute to stress, coping mechanisms to mitigate stress, and the effects of stress are in current trainee doctors. Hence, this study aims to explore the determinants, coping mechanisms as well as th...
Article
Full-text available
Objectives: Exposure to cleaning products has been associated with adverse respiratory outcomes. This study aimed to investigate the medically reported incidence, trends in incidence and occupational determinants of work-related respiratory disorders attributed to cleaning agents and to explore the role of 'Quantitative Structure Activity Relation...
Article
Full-text available
The potential for adverse health effects from internal exposure to Plutonium has been recognised since its discovery in the 1940s. However, in the absence of specific information, potential risks from Plutonium exposure have always largely been controlled through knowledge of radiation exposure risks in general, much of which comes from external ra...
Article
Full-text available
Objectives: To quantitatively evaluate exposure-response associations between occupational exposures to rubber dust, fumes and N-nitrosamines and cancer mortality in the UK rubber industry. Methods: Competing risk survival analyses were used to examine cancer mortality risk in a cohort of 36 441 males aged 35+ years employed in the British rubbe...
Article
Full-text available
Objectives To develop a quantitative historical job-exposure matrix (JEM) for rubber dust, rubber fumes and n-Nitrosamines in the British rubber industry for 1915–2002 to estimate lifetime cumulative exposure (LCE) for a cohort of workers with 49 years follow-up. Methods Data from the EU-EXASRUB database—rubber dust (n=4157), rubber fumes (n=3803)...
Conference Paper
Introduction and objectives Occupational asthma continues to be a significant and costly problem in the UK. The earlier asthma is diagnosed and exposure removed the better the prognosis. It is therefore important that individuals consult a physician as soon as symptoms are suspected. This study aimed to investigate the length of time between sympto...
Conference Paper
Introduction and objectives Regulations published by the Health and Safety Executive (HSE) UK advise health surveillance programmes for some workplaces. Little is known about the proportion of work related asthma cases diagnosed by the health surveillance route. This study aims to investigate the origin of referral to occupational physicians (OP’-s...
Article
Plutonium is a radiologically significant alpha-particle emitter. The potential for adverse health effects from internal exposures due to plutonium intakes has been recognized since the 1940s. The workforce of the Sellafield nuclear facility (Cumbria, UK), includes one of the world's most important groups of plutonium-exposed workers for studying t...
Article
Background Personal protective equipment (PPE) is defined as equipment that protects the wearer’s body against health/safety risks at work. Gloves are a cause of many dermatoses. Non‐glove PPE constitutes a wide array of garments. Dermatoses resulting from these have hitherto not been documented. Objectives To determine the incidence and types of...
Article
Full-text available
Health effects due to the environment are among the most challenging concerns faced by our future. In particular global climate changes. However, the connection between the environment and human health as part of clinician's activities is rather undeveloped. We performed a literature review, finding that many Sentinel Physician Networks have been d...
Article
Background The International Agency for Research on Cancer (IARC) has determined there is sufficient evidence that working in the rubber manufacturing industry increases the risk of cancers of the stomach, lung, bladder and leukaemia and lymphoma. Objectives To examine mortality patterns of a prospective cohort of men from the rubber and cable man...
Article
Full-text available
Background Mental disorders in the workplace are a major public health problem. Knowledge of the impact of the psychosocial work environment on mental and behavioral disorders can assist occupational physicians in the identification and description of occupational risk situations, and help to define priority actions. However, no classification for...
Data
Titles of columns are written without abbreviations. (XLSX)
Data
French version of the FOREC thesaurus. (DOCX)
Data
Number of workers per occupational group and per level of function according the ISCO-08 classification (n = 322 because of one missing value). (DOCX)
Article
Full-text available
Background: In the UK in 2015/16, 1.3 million workers self-reported a work-related illness (WRI) of which an estimated 41% were due to musculoskeletal disorders (incidence rate 550 cases per 100000 people) and 37% were related to stress, anxiety and depression. Little is known about the incidence of WRIs in radiographers. Aims: To analyse the me...
Article
Background: The fraction of ill-health overall attributable to occupational conditions has not been extensively evaluated, thus contributing to the perception of a lesser relevance of education and research in occupational health in respect to other fields of medical research and practice. Aims: To assess the relevance of work-related conditions...
Conference Paper
Full-text available
Background Data on work-related ill-health (WRIH) in the Republic of Ireland (ROI) are inconsistent, with no mandatory requirement for employers to report occupational diseases/illness unless liable for compensation. Aims To compare the incidence of WRIH in ROI, Northern Ireland (NI) and Great Britain (GB). Methods Analysis of voluntary reported,...
Article
Full-text available
Mortality from circulatory disease (CD), ischemic heart disease (IHD) and cerebrovascular disease (CeVD) was investigated in relationship to cumulative doses of external gamma radiation and internal alpha radiation to the liver from deposited plutonium over long follow-up periods in two large cohorts of nuclear workers: the Russian Mayak Worker Coh...
Article
Full-text available
Background Despite high levels of employment among working-age adults in the UK, there is still a significant minority who are off work with ill health at any one time (so-called ‘sickness absence’). Long-term sickness absence results in significant costs to the individual, to the employer and to wider society. Objective The overall objective of t...
Article
Much of the current burden of long-latency respiratory disease (LLRD) in Great Britain is attributed to historical asbestos exposure. However, continuing exposure to other agents, notably silica, also contributes to disease burden. The aim of this study was to investigate the incidence of work-related LLRD reported by chest physicians in Great Brit...
Article
Background: Fragrances are well known to cause allergic contact dermatitis (ACD). Occupationally related cases occur, with certain groups being at higher risk. Objective: To investigate the incidence of occupationally related cases of cutaneous fragrance allergy and to evaluate trends. Method: Data on incident cases of occupational ACD caused...
Article
We describe a 43-year-old epoxy floor layer who developed work-related asthma while exposed to an epoxy hardener based on isophorone diamine (IPDA). Challenge exposures to the curing of the epoxy resin system and subsequently to the polyfunctional amine hardener containing IPDA both elicited delayed asthmatic reactions. This report further indicate...
Article
Background Doctors have a higher prevalence of mental ill health compared with other professional occupations but incidence rates are poorly studied.AimsTo determine incidence rates and trends of work-related ill health (WRIH) and work-related mental ill health (WRMIH) in doctors compared with other professions in Great Britain.Method Incidence rat...
Conference Paper
Background Inequalities in health are often described showing an inverse relationship with social economic group and mortality and morbidity. However, work-related mental ill-health (WRMIH) reported by GPs show highest rates amongst higher socio-economic groups, particularly ‘Lower managerial and professional’ and ‘Intermediate’ occupations. Simila...
Article
Background: Evidence suggests that the medical profession is reluctant to report mental ill-health despite its high prevalence. Aims: To compare differential reporting patterns in the incidence of work-related mental ill-health (WRMIH) affecting doctors with selected comparison occupational groups, as determined by surveillance by general practi...
Conference Paper
Introduction Exposure to cleaning products has been shown to be associated with adverse respiratory outcomes. The aim of this study was to investigate the medically reported incidence and occupational determinants of work-related respiratory disorders attributed to cleaning agents, and to explore the role of a chemical taxonomy and ‘Quantitative St...
Conference Paper
Introduction The UK Sellafield workforce is important for studying potential health risks of plutonium (Pu) exposure. However, several hundred early workers, employed during the period 1952–63, have been excluded from epidemiological studies because their urinalysis results were insufficiently reliable to provide accurate exposure assessment. This...
Conference Paper
Rubber workers in Great Britain were historically exposed to various carcinogenic substances, including β-naphthylamine, which was removed from industrial processes in 1949. The Health and Safety Executive (HSE) initiated in 1967 a prospective occupational cohort study of British rubber industry workers, including men 35 years of age and older, to...
Conference Paper
Background Higher mental ill-health (MIH) prevalence rates have been reported in doctors compared to other professionals. Previous studies have investigated MIH prevalence in doctors, but trends in their incidence rates (IR) of work-related mental ill-health (WRMIH) have not yet been reported. Objectives This study measured IR and IR trends of wor...
Conference Paper
IARC concluded (IARC, 1982, 1987) there is sufficient evidence of a causal association between occupational exposures in the rubber-manufacturing industry and cancer. However, because of the complexity and variety of substances used in the process, a great deal of uncertainty regarding which specific exposures give rise to the increases in cancer r...
Conference Paper
In 1982 IARC concluded that there was sufficient evidence for a causal association between occupational exposures in the rubber manufacturing industry and urinary bladder cancer and leukaemia. To enable evaluations of exposure-response associations in a cohort of men age 35+ employed in the British rubber industry in 1967 with a 49 year mortality f...
Conference Paper
Introduction The calculation of incidence rates of work-related ill-health (WRIH) is essential when assessing employment sectors at risk. The Health and Occupational Reporting network in General Practice (THOR-GP) collects information on WRIH from approximately 250 GPs. To calculate rates, GP numerator data has to be divided by a compatible denomin...
Article
The role of the BDJ is to inform its readers of ideas, opinions, developments and key issues in dentistry - clinical, practical and scientific - stimulating interest, debate and discussion amongst dentists of all disciplines.
Article
Background: Postgraduate education, training and clinical governance in occupational medicine (OM) require easily accessible yet rigorous, research and evidence-based tools based on actual clinical practice. Aims: To develop and evaluate an online resource helping physicians develop their OM skills using their own cases of work-related ill-healt...
Article
Background Occupational medicine (OM) is a varied speciality which ranges from clinical to preventive medicine and therefore offers a wide range of opportunities. However, OM recruitment rates have been variable, suggesting that trainees applying for speciality training may not be considering it as a career. Aims To examine the potential factors t...
Article
Purpose of review: This appraises currently available computer-based ('in silico') models relating the molecular structure of low molecular weight compounds to their respiratory sensitization hazard. The present review places focus on the two main applications of such structure--activity relationship (SAR) models: hypotheses on disease mechanisms...
Article
Full-text available
Vital to the prevention of work-related ill-health (WRIH) is the availability of good quality data regarding WRIH burden and risks. Physician based surveillance systems such as The Health and Occupation Research (THOR) network in the UK are often established in response to limitations of statutory, compensation based systems for addressing certain...
Article
Full-text available
Occupational exposure is an important, global cause of respiratory disease. Unlike many other non-communicable lung diseases the proximal causes of many occupational lung diseases are well understood and they should be amenable to control using established and effective approaches. Thus the risks arising from exposure to silica and to asbestos are...
Article
Hexavalent chromium is the main sensitizer in wet cement and a common cause of occupational allergic contact dermatitis (OACD), especially among workers in the construction industry.(1,2) The European Chromium VI directive(3) transposed into national regulations in France and UK respectively on May and January 2005, prohibits selling or using of hy...
Article
Background Information on sickness absence (SA) duration in general practice is difficult to record. The duration of absence certified by general practitioners (GPs) can be viewed as a prognosis for return to work. The Health and Occupation Research network in General Practice (THOR-GP) collects SA information from GPs associated with cases of work...
Article
Full-text available
Objective To estimate the reported incidence of occupational hypersensitivity pneumonitis (OHP) in the UK and to consider whether the pattern of attributed causation has changed over time. Methods All cases of OHP reported to the SWORD scheme between January 1996 and December 2015 were classified into 1 of 10 categories of the suspected agent. Cas...
Article
Background Work-Related Mental Ill-Health (WRMIH) in physicians could negatively affect wellbeing and subsequently impact patient care. However, physicians may choose to self-manage or bypass normal referral channels. Objectives This study aimed to compare the incidence of WRMIH affecting physicians and selected control occupational groups, as rep...
Article
Full-text available
There exists a great deal of uncertainty as to which specific chemicals present in the rubber products manufacturing industry give rise to the increases in cancer that have been seen to date and which are regarded by the International Agency for Research on Cancer (IARC) as carcinogenic; especially since after this IARC classification, exposures in...
Article
Introduction Inequalities in health have long been described showing an inverse relationship between social class and morbidity. However, analysis of work-related mental ill-health (WRMIH) and socio-economic group reported by General Practitioners (GPs) show incidence rates are greater amongst higher socio-economic groups. The Health & Occupation R...
Article
Background Occupational allergic contact dermatitis (OACD) is one of the most common occupational skin diseases in developed countries, but data about its temporal trends in incidence remain sparse. Objectives The aim of this study is to describe OACD trends in terms of industrial activities and main causal agents in France over the period 2001–201...
Article
Full-text available
Any potential health effects of radiation emitted from radionuclides deposited in the bodies of workers exposed to radioactive materials can be directly investigated through epidemiological studies. However, estimates of radionuclide exposure and consequent tissue-specific doses, particularly for early workers for whom monitoring was relatively cru...
Technical Report
Full-text available
Why the RCP and the RCPCH are tackling this issue Each year in the UK, around 40,000 deaths are attributable to exposure to outdoor air pollution, with more linked also to exposure to indoor pollutants. Air pollution plays a role in many of the major health challenges of our day, and has been linked to cancer, asthma, stroke and heart disease, diab...