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April 9, 2012

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Doctors to look for work-related factors in asthma diagnoses

With an estimated one in six cases of asthma in people of working age either caused or aggravated by work-related factors doctors are being urged to explore the potential occupational causes of the condition when diagnosing patients.

New guidance produced by the Royal College of Physicians (RCP) and funded by NHS Plus advises hospital doctors to question patients with respiratory problems about their job, the materials they work with, and whether their symptoms improve when they are away from work. They also need to be aware of those that carry particular risks, such as laboratory workers, and workers in the chemical industry.

Doctors are also being urged to not solely rely on the patient’s history but to conduct tests such as peak-flow measurements at work and away from work, and skin-prick tests for allergy to substances that could potentially be causing the illness.

Professor John Harrison, director of NHS Plus, said: “About 70 per cent of the UK workforce does not have access to occupational health care. This makes it vital that hospital doctors and respiratory specialists are assessing asthma patients for potential work-related causes and advising appropriate treatment and preventative measures.

“By following this guidance they will offer their patients the best chance of recovery. The guidelines will benefit all doctors and health-care professionals caring for people of working age – a long-standing goal of NHS Plus.”

Dr Paul Nicholson, lead author of the guidance, and who has written about occupational asthma previously for SHP, said: “Highlighting the prevalence of occupational asthma is absolutely key as, too often, work-related factors are overlooked, leading to unnecessary delays in proper investigation and management. When a patient displays signs of asthma, doctors should be enquiring about the patient’s job, the materials they work with, and whether their symptoms improve regularly when away from work.”

The guidance recommends that doctors seek consent from sufferers to communicate with the employer to advise them of the diagnosis and of the need to protect the patient from further exposure. It is available to download here.

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