title: Approaches to the diagnosis and management of occupational asthma amongst UK respiratory physicians.
abstract: This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK. A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure. Participation rates were 42% for the main part of the study. Less than half of consultants specifically reported they would ask whether symptoms improved away from work, and just over a third mentioned examining the patient. All of those interviewed recommended a chest X-ray, and 98% simple spirometry. Eighty-six per cent suggested measurement of serial peak flows, recorded for between 2 and 8 weeks, with measurements taken half-twelve hourly. Less than half advocated a specific flour allergy test, and almost one-quarter (23%) would not perform any immunological test at all. Once a diagnosis of occupational asthma was confirmed, less than two-thirds of those interviewed commented they would recommend some form of exposure reduction, and only 28% specifically stated they would offer compensation advice. The diagnosis of occupational asthma by general respiratory physicians within the UK lacks standardisation, and in some cases falls short of evidence-based best practise.
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton, SK17 9JN Derbyshire, UK. chris.barber@hsl.gov.uk
authors.forename: C M
authors.initials: CM
authors.lastname: Barber
authors.forename: S
authors.initials: S
authors.lastname: Naylor
authors.forename: L M
authors.initials: LM
authors.lastname: Bradshaw
authors.forename: M
authors.initials: M
authors.lastname: Francis
authors.forename: J
authors.initials: J
authors.lastname: Harris-Roberts
authors.forename: R
authors.initials: R
authors.lastname: Rawbone
authors.forename: A D
authors.initials: AD
authors.lastname: Curran
authors.forename: D
authors.initials: D
authors.lastname: Fishwick
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005433:Flour / Q000009:adverse effects; D019538:Health Care Surveys; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control; D011364:Professional Practice / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D006113:United Kingdom