Occupational status variations in disagreements on the diagnosis of cause of death

Studies of occupational status-related risk factors in specific-cause mortality assume that the proportions of disagreements concerning the diagnoses of the cause of death do not vary between different statuses. This assumption was verified by the addition of data concerning the occupation of the decreased (collected at death registration) to a data set comparing the clinicians' and the pathologists' diagnoses at autopsy of the cause of death. It was found that clinicians and pathologists were least likely to agree on the diagnoses of the cause of death of non-manual workers and were most likely to agree on the diagnosis of the cause of death of skilled manual workers. These occupational status differences in diagnostic disagreements reached levels of statistical significance in the neoplasm chapter of the International Classification of Diseases. Artefactual and clinical reasons for these occupational status differences are discussed.