title: Dermatologist and family practitioner practice patterns for occupational contact dermatitis.
abstract: Medical practitioners have a role in the recognition of occupational contact dermatitis. The longer the duration of symptoms before diagnosis, the poorer the outcome. Our objective was to understand practice patterns, barriers and needs for early diagnosis of occupational contact dermatitis. A survey to obtain information on practice patterns was developed based on the literature and interviews with dermatologists and family practitioners. The survey was sent to all dermatologists and a random sample of 600 family practitioners in Ontario. Fifty-seven per cent of dermatologists and 9% of family practitioners report seeing more than 20 patients per year with occupational contact dermatitis. The majority of practitioners report taking a workplace exposure history. Barriers to taking a workplace exposure history include time constraints and lack of knowledge. Reasons for referral to specialists include a lack of expertise, testing facilities and knowledge about workers' compensation, time constraints and inadequate reimbursement, whereas lack of access to specialists is a barrier for referral. Although most practitioners identify a need for further education, a low volume of patients and time constraints are key barriers to continuing education. Opportunities are identified to improve educational initiatives and health services delivery for occupational contact dermatitis, tailored to each practitioner group.
authors.affiliation: Gage Occupational and Environmental Health Unit, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. holnessl@smh.toronto.on.ca
authors.forename: D Linn
authors.initials: DL
authors.lastname: Holness
authors.forename: Shehrina
authors.initials: S
authors.lastname: Tabassum
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
authors.forename: Gary M
authors.initials: GM
authors.lastname: Liss
authors.forename: Frances
authors.initials: F
authors.lastname: Silverman
authors.forename: Michael
authors.initials: M
authors.lastname: Manno
mesh_terms: D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000473:pathology; D009783:Dermatitis, Occupational / Q000175:diagnosis* / Q000473:pathology; D003880:Dermatology; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires