The pharmaceutical industry is an important contributor to the health of the UK economy, with 65 000 people directly employed and many more in support industries [1]. It delivered a net trade surplus of £2.6 billion to the UK economy in 2002 and was rated as the highest value-adding industry, with £78 000 of value added to the economy per industry employee in the same period. It is a highly competitive global industry with significant high-risk, long-term investment in increasingly costly drug discovery and development activity. It takes ~10–12 years to bring a new medicine to market and the average development cost is £350 million, with high attrition rates. The rewards are high for successful transnational players, with pre-tax profits of 30% on sales [2]. The industry presents particular challenges to occupational health practitioners engaged in the delivery of effective occupational health services. The demands of a highly technical work environment must be blended with the need to maintain effective health management in a fast-paced, changing and pressured global business climate. This, combined with a high level of focus on innovation and productivity through human capital development strategies, provides a rich mix of factors to take into account when selecting and implementing health interventions that are appropriate, risk-targeted, cost-effective and acceptable to employees and management. An overview of health hazards in the industry published in 1947 provides a familiar list of headings and exposure issues to today’s pharmaceutical occupational health practitioner. The contemporary collection of reviews in this issue of Occupational Medicine provides an update: so, has anything changed beyond the product names that populate the lists of recognized causes of exposure-related health effects? [3] Providing rational, risk-based advice on the prediction, prevention and management of exposure-related health effects from a diverse and novel range of workplace health hazards requires increasingly specialized technical competences and industry knowledge. Binks reviews occupational toxicology and the control of exposure to pharmaceutical agents at work [4]. He provides insight into the high level of resource investment and multidisciplinary expertise applied to predicting the potential adverse effects of occupational exposure. The industry has pioneered occupational hazard categorization systems and led the way in developing novel approaches to the containment of highly potent biologically active substances. Heron and Pickering review the published evidence for health effects related to exposure to active pharmaceutical ingredients [5]. The literature continues to be dominated by well-known historical clusters of occupational illness burden associated with particular classes of drug compounds and there is a paucity of recently published data. Is this a cause for optimism that the battle has been won? Laboratory animal allergy (LAA) remains an important and potentially life-threatening cause of occupational sensitization, often with significant career implications for those affected. Gordon and Preece [6] present a summary of the state of the art in preventing this condition. They offer encouragement that investment in a policy-driven integrated approach to allergen exposure control can result in a reduction in incidence. The lower level of importance of occupational health interventions, such as health surveillance, compared to other components of LAA risk management systems is noted. However, occupational health practitioners remain well placed to play a key role in facilitating and co-ordinating the Director, Southern Client Services, Aon Health Solutions, 2 Circus Place, London EC2M 5RS, UK. Tel: +44 20 7638 3422; e-mail: alister.scott@aers.aon.co.uk Occupational Medicine 2003;53:354–356 DOI: 10.1093/occmed/kqg114
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