To explore possible explanations for elevated mortality from diabetes among male garment manufacturers and repairers in England and Wales during 1979-1990, we extended analysis by 10 years, looking also at other textile workers and at deaths from ischaemic heart disease (IHD).
We used data on some 3.5 million deaths to compute proportional mortality ratios (PMRs) for diabetes and IHD, standardised for age and social class, in 10 job groups concerned with manufacture of, or work with, textiles. For 1993-2000, we carried out additional analyses by place of birth.
Among men, mortality from diabetes was elevated in nine of the 10 textile job groups, with overall PMRs of 147 (95%CI 131-165) during 1979-90 and 170 (95%CI 144-199) during 1991-2000. Proportional mortality from IHD was also consistently high, although to a lesser extent. In female textile workers, mortality from both diseases was close to that for other occupations. In both sexes, mortality from diabetes and IHD was increased among people born in the Indian sub-continent (PMRs 353 and 139 in men; 262 and 130 in women). In men, the proportion of deceased textile workers who had been born in the Indian sub-continent (11.4%) was much higher than for all occupations (1.8%), but there was no similar differential for women (1.1% v 0.7%). When PMRs for male textile workers were standardised for place of birth, they were lower, but still significantly elevated (133, 95% CI 110-159 for diabetes and 109, 95% CI 105-114 for IHD).
There is no obvious occupational hazard that could explain an increased risk across such a wide range of textile occupations that is specific to men. One possible explanation is uncontrolled residual confounding related to place of birth. This could be tested through suitably designed morbidity surveys.
Keywords: mortality, occupation, diabetes, ischaemic heart disease, textile workers, India, immigrants