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Doctors failing to recognise occupational asthma
The majority of people who develop work-related asthma are not correctly diagnosed by GPs.
This is the conclusion of new research, which analysed electronic patient records of working-age asthmatics and found that GPs do not recognise work-related factors in three quarters of patients.
Researchers at the Institute of Occupational and Environmental Medicine, University of Birmingham found that occupation was only recorded in 14 per cent of cases. In nearly all cases (98 per cent), GPs failed to record if they had asked simple screening questions about whether patients’ asthma symptoms improved at weekends and on holiday.
According to the Society of Occupational Medicine (SOM), which published the study, up to 3000 people develop asthma every year as a result to exposure to materials at work. Early diagnosis of occupational asthma and avoidance of further exposure can lead to complete recovery. However, the Society points out that failures to diagnose the condition and delays in accessing specialist advice mean that two thirds of sufferers never make a full recovery.
Lead author of the research, Dr Gareth Walters, said: “Most workers with new asthma symptoms present to their GPs first, so it is important for health-care professionals working in primary care to recognise when these symptoms might be caused by or related to work. Currently occupational asthma is very costly to the NHS and to society, and an early diagnosis can prevent ongoing debilitating symptoms, time off work and financial loss for the worker.”
SOM is urging GPs to ensure they question, as standard, patients who present with respiratory problems about their job, the materials they work with, and whether their symptoms improve when they are away from work. Doctors should also be aware of those trades that carry particular risks, such as vehicle paint-sprayers, bakers, laboratory workers and workers in the chemical industry. The most common causative agents are isocyanates, flour, cutting oils, laboratory animals and insects, enzymes and wood dusts.
Added Dr Richard Heron, president of SOM. “About 70 per cent of the UK workforce does not have access to occupational health care. This makes it vital that general practitioners are assessing asthma patients for potential work-related causes and referring to specialists where appropriate. More importantly, employers need to be aware of those substances that may cause asthma and, where possible, remove them, or minimise exposure.”
The research is published in the scientific journal, Occupational Medicine. Guidance on the diagnosis, management and prevention of occupational asthma is available on the Royal College of Physicians’ website at: www.rcplondon.ac.uk/resources/diagnosis-management-and-prevention-occupational-asthma-concise-guideline
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