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Respiratory tuberculosis in the potteries.

The Annals of Occupational Hygiene

|January 1, 1989

Summary

Stoke-on-Trent experienced higher tuberculosis notification rates until the 1950s, and higher mortality rates persist today. This is linked to a distinct age distribution and a severe early epidemic, possibly due to environmental factors like silica dust.

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Area of Science:

Epidemiology
Public Health
Environmental Health

Background:

Historical tuberculosis (TB) trends in England and Wales compared to Stoke-on-Trent show regional variations.
Tuberculosis notification rates in Stoke-on-Trent exceeded those in England and Wales until the 1950s.
Mortality rates from tuberculosis in Stoke-on-Trent have remained higher than the national average to the present day.

Purpose of the Study:

To investigate the reasons behind the persistent excess mortality from pulmonary tuberculosis in Stoke-on-Trent.
To compare the age distribution of tuberculosis cases between Stoke-on-Trent and England and Wales.
To explore potential environmental and historical factors contributing to the observed TB trends.

Main Methods:

Comparative analysis of tuberculosis notification and mortality rates from 1930 onwards.
Examination of age-specific incidence and mortality data for pulmonary tuberculosis.
Historical epidemiological investigation considering cohort effects and environmental exposures.

Main Results:

Stoke-on-Trent exhibited higher TB notification rates until the mid-20th century.
A significant excess in TB mortality persists in Stoke-on-Trent.
A distinct peak in TB incidence among elderly individuals in Stoke-on-Trent was observed from the 1950s.
This peak is hypothesized to result from TB reactivation in cohorts affected by a severe early epidemic.

Conclusions:

The persistent excess mortality in Stoke-on-Trent is linked to a unique age distribution of pulmonary tuberculosis.
Reactivation of tuberculosis in older populations, influenced by a severe historical epidemic, is a likely cause.
Poor environmental conditions, including occupational silica dust exposure in the ceramics industry, may have exacerbated the epidemic's severity in Stoke-on-Trent.

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