NHS Digital Data Release Register - reformatted

Institute Of Occupational Medicine (iom) projects

Cancer Incidence and Mortality Experience of a British and an International Cohort of Workers Occupationally Exposed to Styrene
Project 2
Project 3
Project 4

150 data files in total were disseminated unsafely (information about files used safely is missing for TRE/"system access" projects).

🚩 Institute Of Occupational Medicine (iom) was sent multiple files from the same dataset, in the same month, both with optouts respected and with optouts ignored. Institute Of Occupational Medicine (iom) may not have compared the two files, but the identifiers are consistent between datasets, and outside of a good TRE NHS Digital can not know what recipients actually do.

Cancer Incidence and Mortality Experience of a British and an International Cohort of Workers Occupationally Exposed to Styrene — DARS-NIC-169971-Z9M1C

Type of data: information not disclosed for TRE projects

Opt outs honoured: Identifiable, Yes (Section 251 NHS Act 2006)

Legal basis: Health and Social Care Act 2012 s261(7); National Health Service Act 2006 - s251 - 'Control of patient information'., Health and Social Care Act 2012 - s261(5)(d); National Health Service Act 2006 - s251 - 'Control of patient information'.

Purposes: No (Research)

Sensitive: Sensitive, and Non-Sensitive

When:DSA runs 2022-12-01 — 2023-11-30 2023.05 — 2023.05.

Access method: One-Off

Data-controller type: HEALTH AND SAFETY EXECUTIVE, INSTITUTE OF OCCUPATIONAL MEDICINE (IOM)

Sublicensing allowed: No

Datasets:

Cancer Registration Data
Civil Registrations of Death
Demographics

Objectives:

The Institute for Occupational Medicine (IOM) and the Health and Safety Executive (HSE) require NHS Digital data for the purpose of the following research project: "Cancer Incidence and Mortality Experience of a British and an International Cohort of Workers Occupationally Exposed to Styrene".

Styrene is a high-production high-volume chemical with about 18 thousand tonnes produced annually in the manufacture of plastic and synthetic rubber products worldwide. The general population is exposed to very low levels of styrene while occupationally exposed workers may encounter much higher levels of exposure. Around 40 years ago, findings among workers in the synthetic rubber industry suggested an increased risk of leukaemia and lymphoma. However, interpretation of this finding was hampered by co-exposure to other chemicals. Within the reinforced plastics industry, co-exposures to other known and suspected carcinogens are limited. This industry is therefore ideal for studying the potential carcinogenicity of styrene.

The research is proposed as a consequence of the International Agency for Research on Cancer changing its classification in 2019 for the carcinogenicity of styrene from possibly carcinogenic to probably carcinogenic. The main shortcoming in the evidence preventing a conclusion of definite carcinogenicity was the lack of robust evidence from human epidemiological studies from the type of study which is the subject of this agreement.

This data sharing agreement is for a UK-based study, and concerns the collection of data on ~1800 UK study participants who have worked in the glass-reinforced plastics manufacturing industry.

The aims of the UK-based study are:
1) to understand which participants have died or contracted cancer, what the cause of death and/or type of cancer was and when these events occurred
2) to understand whether cancer is occurring in this study population at a rate that is consistent with expectations after adjusting for age, sex and calendar year
3) to compare cancer rates, after the same adjustments, among those with higher and those with lower (or zero) exposure to styrene. This is expected to allow society to understand whether occupational exposure to styrene increases a persons risk of contracting cancer.

This data sharing agreement covers a request for Demographics, Cancer Registration and Civil Registration (Deaths) data from NHS Digital for the ~1800 UK workers from the glass-reinforced plastics industry in order to meet the above aims. The study hopes to achieve its aims by comparing cancer rates in the study population with the general population and by comparing cancer rates in workers exposed to higher levels of styrene with those exposed to lower (or zero) levels of styrene.

Although the study is primarily interested in lymphatic and haematopoietic cancers (cancers of the immune system), other cancers have been implicated. It is also important to look at mortality from other causes as this provides additional important evidence, e.g. whether there exists a healthy worker effect in the cohort (an effect that is well-known in epidemiology that workers exhibit a healthier mortality profile than the general population because of selection effects associated with employment.) In practice, even though lymphatic and haematopoietic cancers are those of primary interest, the study intends to look at a range of other causes to see if any of them are in excess and whether any excess found might be related to styrene exposure. This is standard practice for epidemiological studies of this type.

The Institute of Occupational Medicine (IOM) wishes to obtain mortality, cancer registration and demographic data for this group of workers from across England and Wales for all available data years. IOM requests that identifiable data are returned to ensure that there are no transcription errors and that the correct events are allocated to the current individual. Once the matching has been completed, IOM will destroy the identifiers that have been received from NHS Digital. IOM needs to have deaths, cancer registrations and reason for removal from the NHS for as many years as possible, and for all of the workers in the cohort from across England and Wales, to ensure the study has maximum statistical power. This is the only way to carry out such occupational cohort studies. There are no alternative, less intrusive ways of achieving the purpose. IOM will remove day of death and day of birth from the analysis data sets to further minimise the probability of study participants being identified by those carrying out the statistical analysis of the study data. Only those data fields necessary to meet the objectives of the study have been requested.

The data controllers for the UK study are the Institute of Occupational Medicine (IOM) and the Health and Safety Executive (HSE). The IOM will also be processing the data.

The IOM is a registered charity whose mission is to understand occupational, environmental and public health risks in order to make our world a healthier and more sustainable place to live. The data processing described here is to support scientific and statistical research. Specifically, data is processed under the following articles of the Data Protection Act 2018:

Article 6 (1) (f) Legitimate interests: the processing is necessary for your legitimate interests or the legitimate interests of a third party unless there is a good reason to protect the individuals personal data which overrides those legitimate interests.

The data is required for a research project - and therefore IOM process the special category data (health data) under the following article of GDPR - Article 9 (2) (j): processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject.

Processing personal data is necessary for IOM's legitimate interests. The data to which access is requested are proportionate and necessary to achieve those interests. IOM has completed a legitimate interests assessment (LIA) and is satisfied that the interests of the data subjects do not override IOMs legitimate interests; that they would reasonably expect the processing and it would not cause unjustified harm. The IOM have worked closely with the industry (via the HSE and the Trades Union Congress) to notify glass-reinforced plastic workers of the existence of the study. A worker leaflet was produced to notify individuals of the opportunity to opt out of the study. National data opt-outs will also be applied.

The Trades Union Congress are of the view that it is acceptable for the study to proceed without prior consent from the people whose confidential patient information is being used. The Trades Union Congress consider that the study is significant and will improve knowledge of the possible cancer risk from occupational exposure to styrene.

This research study is funded by the HSE, and the data from this study were originally assembled by the HSE in the late 1980s/early 1990s. The data, which consists of information about the identity and work situation of approximately 1800 workers employed in the glass-reinforced plastics manufacturing industry between ~1961-1988, was assembled in order to assess whether occupational exposure to styrene was associated with an increased risk of cancer. The proposed further assessment of the long-term mortality and cancer experience of these workers essentially amounts to an update of the original study in line with the original purpose, albeit carried out by IOM and facilitated by HSE via sharing of the original study dataset. Although HSE will not be in receipt of any new information about cancer registrations and deaths, or any demographic information, HSE will retain ownership of the original data, and be responsible for facilitating any future updates. As such, it is appropriate for HSE to be regarded as a data controller for the purposes of the exercise to update the cancer and mortality experience of these workers.

The HSEs UK GDPR legal bases are Article 6(1)(e) - processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller given HSEs statutory responsibility under the Health and Safety at Work Act to carry out appropriate research in order to fulfil its duty to protect the health and safety of British workers, and Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes, as the purpose of this scientific research is to help determine the long term health implications of around 1800 glass-reinforced plastics manufacturing industry workers who were exposed to styrene, ultimately to inform future health and safety policy and procedures that are designed to protect future generations of workers in this sector.

The purpose of processing the data is for reasons of public health and research to further understand whether styrene is a carcinogen. The data will be stored securely, not published in a way that identifies anyone, only used for the purposes for which it is collected, and kept only as long as is necessary to undertake the research.

Past workers in the industry could bring medico-legal cases against employers if styrene is found to be a carcinogen; and/or the cancer type involved with the associated exposure circumstances may get added to the list of prescribed diseases, maintained by the Industrial Injuries Advisory Council.

Expected Benefits:

Estimates of how many people in the UK are occupationally exposed to styrene are not available, however styrene is one of the top 50 chemicals manufactured in the world. Occupationally, exposure occurs in styrene production, production of polystyrene and other styrene-containing polymer resins, plastics and rubber products fabrication, fabrication of reinforced-polyester plastics composites and use of products containing styrene such as floor waxes and polishes, paints, adhesives, putty, metal cleaners, autobody fillers and varnishes. Globally, it is estimated that more than 15,000 industrial plants in many countries produce or use styrene in the manufacturing of polymeric products.

The impact on occupational health of this research depends on the findings. There are three possibilities:
(i) No association is found between occupational exposure to styrene and increased risk of cancer;
(ii) No association is found, but there is a suggestion that further work is required to clarify matters; or
(iii) There is an association found.

The findings in (i) will provide reassurance that workers occupationally exposed to styrene have not been exposed to a cancer risk (at the levels of exposure encountered by the members of this study).

The findings in (ii) will be somewhat reassuring, but further research may be required to clarify the carcinogenicity of styrene.

The findings in (iii), depending on the strength of any association found, may mean that further research is required to confirm the findings (this is often the case in occupational studies of this kind) or the findings may mean that a causal conclusion can be drawn that occupational exposure to styrene (at the levels encountered by the study participants) are associated with an increased risk of cancer.

For current workers, it will depend whether current exposure levels are at or above those associated with the increased cancer risk, as to how important the findings are. If current exposures are substantially lower, then appropriate reassurance can be provided however, if not, it could be that occupational exposure limits may need to be lowered and that further control of workplace exposures are required.

For those who have worked with styrene in the past or who continue to work with styrene, it is important to clarify whether such workers have been exposed to a carcinogenic hazard, for the reasons mentioned above. The UK part of the study is funded by the HSE and they will determine the relevance of any findings from a UK regulatory point of view.

In line with IOMs legitimate interest for processing the data, workers in the industry, management, trades unions and regulators are expected to receive the benefit of the processing. If this work provides evidence that styrene is carcinogenic, then regulators may need to review occupational exposure limits, and the management, trades unions and workers themselves may need to review their work practices to minimise any carcinogenic risks. The focus of research may shift from determining, whether or not styrene is carcinogenic, to what cancers does it cause, and what is the nature of any exposure-response relationships for the different cancer sites implicated.

This study is anticipated to help clarify whether or not occupational exposure to styrene increases a persons risk of contracting cancer. This will have consequences for the classification, labelling, and packaging of styrene and styrene containing products. Modelling of quantitative exposure levels of styrene will allow risk assessment and may form the basis for revision of the current threshold limit values that are based on acute effects.

The dissemination plans are for the results to be published in the peer-reviewed scientific knowledge and so to add to the scientific evidence base of this important topic. The presentations at conferences allow interaction with fellow scientists, some of whom may have a direct interest in this topic. Production of the leaflet for industry allows senior officials within the industry and the workforce representatives and workforce to have a clear understanding of the outcomes and implications of the research. The findings are expected to be evaluated by regulators and by other influential bodies such as the World Health Organisations International Agency for Research on Cancer.

It is anticipated that the findings of the UK study will be available in 2023.

Outputs:

Outputs are expected to include:
Submissions to peer-reviewed journals
Worker leaflet in lay language for the industry
IOM website updates
Twitter/LinkedIn posts
Conference presentations/posters
Short report for funder

No identifiable data will be included in any outputs from this project. All outputs will be aggregated with small numbers suppressed.

The results of the UK study are anticipated to be presented at appropriate scientific conferences such as EPICOH Scientific Committee on Epidemiology in Occupational Health 2023 and the UK/Ireland 1-day meeting on Occupational and Environmental Epidemiology in 2023.

IOM anticipate that the study results will be published in the journal Occupational and Environmental Medicine.

In addition, IOM are expecting to present the results of the study to the industry and its workforce. HSE would distribute a leaflet prepared by IOM in lay language explaining the results of the study, highlighting any implications for policy, practice and future research. IOM also plan to send the leaflet to the Trades Union Congress (TUC) for onward distribution to the relevant workers (i.e. those occupationally exposed to styrene).

The findings are intended to be made available on the IOM website as a blog post and possibly in other dissemination materials such as infographics. It may also be disseminated via IOMs research newsletter. The findings are also planned to be made available via Twitter and LinkedIn. The exact nature and extent of this would depend on the findings of the research.

It is hoped that the UK study will be published in 2023. The conference presentations and other dissemination materials would be made available as soon as possible once the results have been published.

Processing:

The data from this study were originally assembled by the Health and Safety Executive (HSE) in the late 1980s/early 1990s and consists of work histories and some demographic data for ~1,800 workers in the glass reinforced plastics manufacturing industry. The HSE will provide this cohort data to the Institute for Occupational Medicine (IOM) under a separate Agreement between HSE and IOM.

The Institute for Occupational Medicine (IOM) will send the name(s), sex, date of birth and postcode of the ~1,800 workers to NHS Digital for the purpose of understanding any deaths, cancer registrations or exits from the NHS (as listed in the demographics dataset) experienced by the cohort. Once the linkages have been carried out by NHS Digital, the resulting mortality, cancer and demographics data will be sent to IOM (all uploads and downloads to and from NHS Digital will be made by authorised IOM staff using the NHS Digital secure electronic file transfer service). IOM requests that participant names, sex and date of birth are returned alongside the unique study ID to ensure that there are no transcription errors and that the correct events are allocated to the correct individuals.

Data from NHS Digital will be linked to each workers occupational data from the Health and Safety Executive (HSE). The results of the matching will be checked and a pseudonymised data set created that will be used for analysis within IOM. No names will be contained in the analysis data set, nor any other identifiers such as postcode. Dates of birth, dates of cancer registrations and dates of death will only be stored as month and year. All identifiable information will be stored separately to the pseudonymised analysis dataset, and identifiers provided by NHS Digital will be destroyed once the matching is complete.

Data at IOM will be held on a secure cloud-based server. This is using Box.com (UK) Ltd, with the highest security level in place and where the data are only accessed by the study principal investigator and the statistical analyst. Data will be stored in a fully password-protected study folder and only accessed by authorised members of the study team who are substantive employees of IOM. No data will be downloaded onto local devices. Data will be accessed remotely via a secure VPN with two factor authentication.

Box.com (UK) Ltd supply IT infrastructure for IOM and are therefore listed as data processors. They supply support to the system, but do not access data. Therefore, any access to the data by Box.com (UK) Ltd held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.

IOM will employ standard epidemiological techniques to analyse the data in order to understand whether exposure to styrene is associated with an increased risk of cancer. Two main types of analyses are contemplated, one that compares the cancer rates in the study population with the general population of England and Wales, and another in which cancer rates in workers with assessed higher exposure to styrene are compared to workers with assessed lower/zero exposure.

All NHS Digital data will be destroyed when this Data Sharing Agreement expires, and the data that originated from HSE will be returned to HSE.

Project 2 — DARS-NIC-149506-6C4GX

Type of data: information not disclosed for TRE projects

Opt outs honoured: Y

Legal basis: Section 251 approval is in place for the flow of identifiable data

Purposes: ()

Sensitive: Sensitive

When:2017.09 — 2017.11.

Access method: Ongoing

Data-controller type:

Sublicensing allowed:

Datasets:

MRIS - Members and Postings Report

Objectives:

Inorganic lead compounds are classified, by the International Agency for Research on Cancer (IARC) which is an agency of the World Health Organisation, as 'probably carcinogenic to humans'. This is based on ‘sufficient evidence of carcinogenicity in experimental animals’ and 'limited evidence of carcinogenicity in humans’.

Much of the epidemiological evidence for carcinogenic effects in humans comes from studies of lead workers. However, previous studies have often involved relatively small numbers of workers and suffered from methodological constraints such as limited information on co-exposures to other risk factors or poorly characterised exposure assessments.

Given the length of follow-up, the large size of the cohort and the relatively high exposures that they experienced (as documented by blood lead levels), the proposed study would make a significant contribution to the evidence on the carcinogenicity of lead exposure.

This study will fill an important knowledge gap identified as a research priority by IARC.

Expected Benefits:

At present there is no clear evidence that occupational exposures in the lead manufacturing industry increases workers’ cancer risks. The International Agency for Research on Cancer (IARC) has occupational exposure to inorganic lead as ‘probably carcinogenic to humans’ based on limited evidence of carcinogenicity in humans. Therefore it is a priority to clarify whether exposure increases risk of cancer.

This study will identify whether there are any health risks from having worked in the lead manufacturing industry in the UK ( and elsewhere in the pooled information).

On completion of this work, there will be a better understanding of whether work in the lead industry poses a cancer risk, and if so what exposures give rise to an increased cancer risk. This analysis is part of the most definitive study of work in this industry ever undertaken and the results will influence and inform international occupational health policy makers, including the Health and Safety Executive.

The results will have the potential to directly influence the health and safety policies of the lead industry and the actions they will take will have a direct benefit for workers and reduce the burden on the health system.

Outputs:

Once the processing for this study has been completed, there will exist an international data sets in relation to cancer incidence risks within the lead manufacturing industry. As a consequence of this study the International Agency for Research on Cancer will revisit their classification of work in the lead industry.

The institute of Occupational Medicine have strong links with the Health and Safety Executive and will also report their findings directly to the HSE.

There will also be a peer-reviewed scientific publication of an analysis of the UK, Finnish and US cancer registration data. This is expected to be published one of the following journals;

• Occupational and Environmental Medicine
• Journal of Occupational and Environmental Medicine
• American Journal of Industrial Medicine
It is expected to be submitted for publication mid 2017.

Example of a previous publication can be found on BMJ http://oem.bmj.com/content/72/9/625

The relevant Trade Unions will also be informed of the outputs so they can make their members aware.

Processing:

Only substantive employees of Institute of Occupational Medicine (IOM) will have access to the disseminated data and only for the purposes described in this document.

Standard Office for National Statistics term s and conditions apply to the mortality data already being held by this study.

This cohort is already flagged with NHS Digital. IOM would like to obtain cancer register data linked to the Lead study cohort.

Identifiable data is being requested and includes; NHS Number, name, DOB, sex as well as cancer site, type and morphology data and member number. Identifiable data has been requested to ensure the quality of the linkage and the subsequent analysis.

The cancer data will be analysed, along with the occupational data (blood lead measurement, factory and process codes) to compare exposures, types and rates and will be compared will national statistics.

De-identified data in the format of IARC member number, cancer site, type and morphology linked to occupational data will be supplied to IARC via a secure transfer method. No identifiable data will be shared with IARC, including date of the cancer. IARC do not hold any identifiers for the cohort, so cannot re-identify the cohort on receipt on the data from IOM. IOM are the data controller for the data supplied to IARC.

The de-identified data being shared with IARC will be pooled with other international study outputs to increase the statistical information available to inform IARCs classification and occupational policy makers.

The Institute of Occupational Medicine are prohibited from providing identifiable data to International Agency for Research on Cancer.

The Institute of Occupational Medicine, as Data Controller, are responsible for the disseminated data, including the data shared with the International Agency for Research on Cancer. Therefore, IOM will be considered in breach of this agreement should IARC break any of the conditions of the Data Sharing Agreement agreed between IOM and IARC.

If IARC does not respond in a timely manner to a request made for necessary evidence to ensure that the terms of their data sharing agreement with IOM are being abided by, then IOM is responsible for informing NHS Digital of this.

IOM are responsible for ensuring that data destruction is completed at IARC when required.

Project 3 — DARS-NIC-335133-K2Y2S

Type of data: information not disclosed for TRE projects

Opt outs honoured: Y

Legal basis: Approved researcher accreditation under section 39(4)(i) and 39(5) of the Statistical Registration Service Act 2007 , Section 251 approval is in place for the flow of identifiable data

Purposes: ()

Sensitive: Sensitive, and Non Sensitive

When:2016.09 — 2017.02.

Access method: Ongoing

Data-controller type:

Sublicensing allowed:

Datasets:

MRIS - List Cleaning Report
MRIS - Bespoke

Objectives:

At present there is no clear evidence that occupational exposures in the hard-metal manufacturing industry affects the risks of disease, such as lung cancer, or death. This study aims to assess the evidence for or against such associations, by comparing the death rates in those who have worked in the industry with those in the general population. It will also investigate whether death rates differ between those with lower and higher exposures arising from work in the industry.

Expected Benefits:

At present there is no clear evidence that occupational exposures in the hard-metal manufacturing industry affects the risks of disease, such as lung cancer, or death. The International Agency for Research on Cancer (IARC) has classified this work in the hard metal manufacturing industry as ‘probably carcinogenic to humans’. Therefore it is now a priority to clarify whether exposure increases risk of cancer.
This study will identify whether there are any health risks from having worked in the hard-metal manufacturing industry in the UK or elsewhere.
On completion of this work, there will be a better understanding of whether work in the hard-metal industry poses a cancer risk, particularly for lung cancer, and if so what agents are implicated. This is the most definitive study of work in this industry ever undertaken and the results will influence and inform occupational health policy makers, including the Health and Safety Executive.
The results will directly influence the health and safety policies of the hard metal industry and the actions they will take will have a direct benefit for workers and reduce the burden on the health system.

Outputs:

There will be a peer-reviewed scientific publication of the UK analysis and at least one peer-reviewed publication for the international pooled analysis. These are expected to be published in the following journals;
• Occupational and Environmental Medicine
• Journal of Occupational and Environmental Medicine
• American Journal of Industrial Medicine
These are expected to be submitted for publication mid to late 2016.
Once the processing for this study has been completed, there will exist national and international data sets in relation to cancer incidence and mortality risks within the industry. It’s possible that the International Agency for Research on Cancer will revisit their classification of work in the hard-metal industry as a consequence of this study.

Processing:

Institute of Occupational Medicine (IOM) aim to carry out an analysis of the mortality experience of workers in the hard-metal manufacturing industry. The mortality data will be linked to occupational histories for individuals within the study cohort in order to determine what role (if any) work in the industry may have had for certain causes of death that are of particular interest on the basis of previous epidemiological studies and toxicological data. IOM will calculate standardised mortality ratios using mortality data for England and Wales and the West Midlands for comparison and also compare mortality rates in those workers with higher exposures to those with lower exposures.
HSCIC will supply IOM identifiable mortality, latest demographic data and NHS de-registration data who will perform their analysis against the general population.
IOM will supply fully de-identified (as agreed with ONS and specified by CAG) data to the international study coordinators University of Pittsburgh. This will be month and year of birth and death and cause of death data. University of Pittsburgh does not hold any data for these individuals and therefore cannot re-identify this cohort. They will be supplied with a member number in order to check data quality with IOM only. The study ID number will be held electronically at IOM on a separate secure server which is only use for epidemiological studies involving sensitive personal data.
A nested case-control study of lung cancer is also planned to take into consideration the influences of lifestyle, such as smoking and employment in other industries. HSCIC will co-ordinate the consenting of this cohort. HSCIC will use the informants details supplied on the death registrations details (as agreed by ONS) to send consent material. IOM will only receive consented participants details. Once an informant of a member of the cohort who died from lung cancer has consented, IOM will conduct a short telephone interview to gather information on lifestyle and employment history of the case. For each of these cases, five controls will be contacted. The controls will be contacted via the HSCIC to either the GP if they are alive to ask for the consent material to be passed on, or via the informant on the death certificate.

Project 4 — DARS-NIC-323309-L2G9T

Type of data: information not disclosed for TRE projects

Opt outs honoured: N, Y

Purposes: ()

Sensitive: Sensitive

When:2016.04 — 2017.02.

Access method: Ongoing

Data-controller type:

Sublicensing allowed:

Datasets:

MRIS - Cause of Death Report
MRIS - Flagging Current Status Report
MRIS - Scottish NHS / Registration
MRIS - Bespoke

Objectives:

This research from the Institute of Occupational Medicine (IOM) sets out to determine whether specific chemicals used within the rubber manufacturing process increase the risk of cancer.
The aim is to assess whether working in this industry has increased the risk of dying from certain types of cancer, such as lung cancer, bladder cancer, leukaemia and cancers of the larynx, oesophagus, prostate, brain and liver. This will be done by calculating standardized mortality ratios using mortality data for Great Britain. The EXASRUB database, a database of chemical exposures in the European rubber and cable manufacturing industry (see http://exasrub.iras.uu.nl/) will be used to investigate exposure-response relationships to better understand the role of individual chemicals or mixtures of chemicals and any risks that might be identified.
The IOM are requesting to track approximately 40,000 workers, who were aged 35 or over in 1967 and worked in the rubber industry, with the HSCIC in order to receive updates in relation to deaths and cancers.

Expected Benefits:

The whole aim of the study is to better understand the burden of disease associated with work in the rubber and cable manufacturing industry and to better understand the nature of exposure-response relationships, for agents known and strongly suspected as causing cancer. This will inform occupational health policy-makers such as the HSE and impact descriptions of optimum working practices in the industry, not just in the UK but throughout Europe and the rest of the world.
The outputs from this research will directly benefit those in the industry by identifying risk factors which will inform preventative measures, reducing the risk of disease and the burden on healthcare,
It is anticipated that the work will be completed during 2016.

Outputs:

There will be at least three peer-reviewed scientific publications to contain the analyses described above. The names of these publications are:
• Extended Follow-up of a cohort of workers in the rubber and cable manufacturing industry.
• Dose response relationships in a cohort of workers in the rubber and cable survey.
• An international pooled cohort study of workers in the rubber and rubber products manufacturing industry.
Results will also be fed back to the Health and Safety Executive and made available to HSCIC and ONS.
Outputs will contain no record level data and will be aggregated in line with the requirements of the HES Analysis Guide

Processing:

The Institute of Occupational Medicine (IOM) would receive data from the Health and Safety Executive (HSE) in relation to workers who took part in an original study undertaken by the HSE predecessor in 1967. IOM would then pass NHS number, DOB data and if applicable date of death to the HSCIC to trace the cohort and provide NHS exits, cancer and mortality data to IOM. HSCIC will also trace members of the cohort using the paper records where deaths have occurred before computerisation in 1991.
Identifiable mortality data will be received by the IOM part of the research team in order to determine how the mortality and, cancer incidence rates among the cohort, compare to those expected on the basis of the general population for Great Britain.
Named IOM researchers will be working with identifiable data to enable the appropriate mortality data to be matched to the correct cohort member.