title: Understanding health beliefs and behaviour in workers with suspected occupational asthma.
abstract: BACKGROUND
  Long delays from symptom onset to the diagnosis of occupational asthma have been reported in the UK, Europe and Canada and workers are often reluctant to seek medical help or workplace solutions for their symptoms. Reducing this delay could improve workers' quality of life, and reduce the societal cost of occupational asthma. This study aimed to explore reasons behind such delays.
  
  
  METHODS
  A purposive sample of 20 individuals diagnosed with, or under investigation for, occupational asthma (median age = 52; 70% male; 80% white British) undertook a single semi-structured interview. Interviews were transcribed verbatim and thematic analysis was undertaken in order to explore health beliefs and identify barriers to diagnosis.
  
  
  RESULTS
  Four themes were identified: (1) workers' understanding of symptoms, (2) working relationships, (3) workers' course of action and (4) workers' negotiation with healthcare professionals. Understanding of symptoms varied between individuals, from a lack of insight into the onset, pattern and nature of symptoms, through to misunderstanding of what they represented, or ignorance of the existence of asthma as a disease entity. Workers described reluctance to discuss health issues with managers and peers, through fear of job loss and a perceived lack of ability to find a solution. The evolution of workers' understanding depended upon how actively they looked to define symptoms or seek a solution. Proactive workers were motivated to seek authoritative help and negotiate inadequate healthcare encounters with GPs.
  
  
  CONCLUSIONS
  Understanding workers' health beliefs will enable policy makers and clinicians to develop better workplace interventions that may aid diagnosis and reduce delay in identifying occupational asthma.
authors: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. Electronic address: gaxwalters@hotmail.com.
authors: Gareth I
authors: GI
authors: Walters
authors: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors: Andy
authors: A
authors: Soundy
authors: Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK.
authors: Alastair S
authors: AS
authors: Robertson
authors: Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK.
authors: P Sherwood
authors: PS
authors: Burge
authors: Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors: Jon G
authors: JG
authors: Ayres
mesh_terms: D059366:Asthma, Occupational / Q000139:chemically induced / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D017132:Workplace / Q000706:statistics & numerical data
keywords: Asthma diagnosis; Occupational asthma; Qualitative research