title: Occupational asthma and work-exacerbated asthma: factors associated with time to diagnostic steps.
abstract: BACKGROUND
  Little is known regarding the factors associated with the times for patients' first physician visit, the first physician suspicion of work-related asthma (WRA), and final diagnosis after the onset of WRA symptoms. This study examined individual and work-related factors that are associated with longer times to these diagnostic milestones among groups with occupational asthma (OA) and work-exacerbated asthma (WEA).
  
  
  METHODS
  Suspected WRA cases were identified from an occupational lung disease clinic and claimants to the Ontario Workplace Safety and Insurance Board (100 patients each). Questionnaire administration and chart review were undertaken.
  
  
  RESULTS
  Eighty participants were classified as having sensitizer-induced OA and 87 as having WEA. For the OA group, the risk factors for delay included male sex, being unmarried, low education, and lack of awareness of association of symptoms with work. Other factors included older age, being the sole income earner, and lack of knowledge of the Workplace Hazardous Materials Information System program. For WEA, lower household income, lower education, absence of a health-and-safety program at work, absence of a union, and lack of awareness of OA and of agents at work that could affect asthma significantly increased the time to diagnostic milestones.
  
  
  CONCLUSIONS
  Different factors affect the diagnostic milestones for OA and WEA. Findings suggest a need for educational programs for workers who are at risk of OA and WEA and a need for further primary care physician education on WRA.
authors.affiliation: Gage Occupational and Environmental Health Unit, Toronto, ON, Canada M5T 1R4.
authors.forename: Marlene S
authors.initials: MS
authors.lastname: Santos
authors.forename: Hyejung
authors.initials: H
authors.lastname: Jung
authors.forename: Javad
authors.initials: J
authors.lastname: Peyrovi
authors.forename: Wendy
authors.initials: W
authors.lastname: Lou
authors.forename: Gary M
authors.initials: GM
authors.lastname: Liss
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology*; D001364:Awareness; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology*; D009864:Ontario; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors