title: Processes of care for individuals with work related asthma: treatment characteristics and impact of asthma on work.
abstract: The prevalence of asthma among working adults continues to rise each year. The California Department of Health Services conducts surveillance of work related asthma (WRA) to classify each work related exposure using Doctor's First Reports of Occupational Illness and Injury (DFRs). Using a cross-sectional, descriptive, comparative design, additional interviews were conducted and medical records were reviewed to explore workers' and providers' perceptions of follow up care. Two cohorts were compared: workers with WRA who belonged to a large, single HMO (n = 79) and workers with WRA who underwent follow up outside this HMO (n = 76). The interview asked about providers seen, tests ordered, and the impact of asthma on work. The HMO clients were significantly more likely than the non-HMO clients to see occupational medicine specialists (p = .004) and have pulmonary function testing (p = .049) during initial treatment. Twenty-four percent of clients currently working reported missed workdays caused by asthma in the past 6 months. The findings indicate management of WRA varies by health care system in California.
authors.affiliation: University of California San Francisco, School of Nursing, Department of Community Health, USA.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Roberts
authors.forename: Susan
authors.initials: S
authors.lastname: Janson
authors.forename: Marion
authors.initials: M
authors.lastname: Gillen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flattery
authors.forename: Robert
authors.initials: R
authors.lastname: Harrison
mesh_terms: D000041:Absenteeism; D000328:Adult; D000359:Aftercare / Q000523:psychology / Q000592:standards*; D001249:Asthma / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006279:Health Maintenance Organizations / Q000592:standards*; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D009785:Occupational Health Nursing; D009786:Occupational Health Services / Q000592:standards*; D009787:Occupational Medicine / Q000592:standards; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D011159:Population Surveillance; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome