"Health Watch": the Australian petroleum industry health study surveillance programme

Social class as indicated by area of residence: a mortality study within an Australian industrial population

The influence of social class on morbidity and mortality is well known and, in many epidemiological settings, its role as a potential confounding variable must be addressed. In occupational studies, particularly those based within a single industry, it is difficult to measure social class by scales based on occupational prestige. In a population study within the Australian petroleum industry, the all-cause mortality of males has been examined by social class, as indicated by area of residence, specifically, postcode. Rates of mortality were higher in the lower social classes, and the gradient was similar to that observed previously. The mortality rate of the lowest social class group relative to the highest was 1.73, and the test for trend was significant (p = 0.003). Whilst adjustment for smoking reduced the gradient somewhat, a social class effect remained.

The health-promoting workplace: an integrative perspective

The workplace is an important setting, affecting the physical, mental, economic and social wellbeing of workers, and, in turn, their families. Health of workers has many determinants, and a multidisciplinary, integrated approach is important. An overview of trends in workplace health promotion shows that current thinking has changed from a narrowly based risk-factors approach aimed at individual behaviour changes, to an integrative approach aimed at creating health-promoting workplaces. The health-promoting workplace has 'an all-encompassing approach that empowers workers and employers to improve all facets of their health'. There are gaps in knowledge, at the state and national levels, relevant to the planning and assessment of workplace health. A national information network is needed to facilitate better links between public health practitioners and researchers in advancing the health of working Australians.

A prospective study in the Australian petroleum industry. I. Mortality

This paper reports the mortality experience of employees of the Australian petroleum industry from 1981 to 1989. Two surveys by personal interview incorporated more than 15,000 employees representing 92% of the eligible population. Subjects were included in the analysis after completing five years of service in the industry. At the time of this report the cohort does not include sufficiently large numbers of women for useful analysis; results presented are restricted to men. By 31 December 1989, 76,529 person-years of observation had accumulated for male mortality with 241 deaths. The standardised mortality ratio (SMR) analysis showed a favourable mortality experience for most causes with overall cancer rates slightly lower than those of the national population. Whereas deficits were seen in some cancer sites, notably lung cancers (SMR 0.5, 95% confidence interval (95% CI) 0.3-0.8), mortality for lymphohaematopoietic cancers, notably leukaemia (SMR 1.6, 95% CI 0.6-3.4) suggested increased risk. The SMR for cancers of the pleura was 3.9 (95% CI 0.8-11). Two of the three cases seen had previous employment, however, in industries with likely exposure to asbestos.

Current mortality in the Australian petroleum industry: the healthy-worker effect and the influence of life-style factors

A surveillance system, to monitor mortality and cancer morbidity on a continuing basis, has been established in the Australian petroleum industry. A baseline survey of 11,573 employees, by personal interview, was carried out in 1981-1983. By the end of June 1986, 33,712 person-years of observation in men had accrued, with 109 deaths. Standardized mortality ratios, with the Australian national death rates as reference, indicate that in terms of mortality from all causes and in mortality from the more common diseases, the death rates in this population are substantially lower than in the national population. Standardization was also carried out in the case of employed men, with data from contributors to the Commonwealth superannuation fund as reference, in order to provide a more appropriate contrast. The risks of tobacco smoking are demonstrated, as is the probable protective effect of mild-to-moderate alcohol consumption. The advantages to the occupational physician in being able to describe current mortality patterns, and in being able to delineate "at-risk" groups are discussed, particularly in the context of health promotion and other interventions.