title: Assessment of the potential effects of population changes in attitudes, awareness and beliefs on self-reporting of occupational ill-health.
abstract: BACKGROUND
  It is important to take account of the effects of population changes in attitudes, awareness and beliefs when interpreting temporal trends in self-reported occupational ill-health. Aim To assess how changes in population attitudes, awareness and beliefs have influenced trends in the self-reporting of occupational and other types of ill-health.
  
  
  METHODS
  A review of relevant literature was carried out. The criterion for inclusion was that papers must be based on empirical evidence; theoretical discussion papers were included only where empirical examples were included.
  
  
  RESULTS
  Several examples were identified where raised awareness of a health problem following intended or unintended publicity was followed by an increase in self-reports of this problem. The magnitude of the increase varied widely according to the situation. One example was identified where self-reports decreased following a publicity programme designed to prevent the occurrence and worsening of the problem in the population. Potential mechanisms identified as influencing changes in self-reporting of ill-health following raised awareness included changes in symptom/illness management, perception of symptoms, tolerance of symptoms, recognition and diagnosis of illness, attribution of illness; social desirability and legitimacy and recall.
  
  
  CONCLUSIONS
  The effects of changes in population attitudes, awareness and beliefs on trends in self-reports of occupational and other illness are difficult to predict for any given situation.
authors.affiliation: Epidemiology and Medical Statistics Unit, Health & Safety Executive, Bootle, Merseyside, UK. katherine.abba@hse.gsi.gov.uk
authors.forename: Katharine
authors.initials: K
authors.lastname: Abba
authors.forename: Simon
authors.initials: S
authors.lastname: Clarke
authors.forename: Rosanna
authors.initials: R
authors.lastname: Cousins
mesh_terms: D001364:Awareness; D003469:Culture; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008568:Memory; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology*; D011287:Prejudice; D011634:Public Health; D012649:Self Concept; D012928:Social Desirability