title: Health surveillance for occupational asthma in the UK.
abstract: BACKGROUND
  Periodic health surveillance (HS) of workers can identify early cases of occupational asthma. Information about its uptake and its content in the UK is lacking.
  
  
  OBJECTIVE
  To identify the overall levels of uptake and quality of HS for occupational asthma within three high-risk industry sectors in the UK.
  
  
  METHODS
  A telephone survey of employers, and their occupational health (OH) professionals, carried out in three sectors with exposures potentially capable of causing occupational asthma (bakeries, wood working and motor vehicle repair).
  
  
  RESULTS
  A total of 457 organizations participated (31% response rate). About 77% employed <10 people, 17% between 10 and 50 and 6% >50. Risk assessments were common (67%) and 14% carried out some form of HS for occupational asthma, rising to 19% if only organizations reporting asthma hazards and risks were considered. HS was carried out both by in-house (31%) and external providers (69%). Organizational policies were often used to define HS approaches (80%), but infrequently shared with the OH provider. OH providers described considerable variation in practice. Record keeping was universal, but worker-held records were not reported. HS tools were generally developed in-house. Lung function was commonly measured, but only limited interpretation evident. Referral of workers to local specialist respiratory services was variable.
  
  
  CONCLUSIONS
  This study provided new insights into the real world of HS for occupational asthma. We consider that future work could and should define simpler, more practical and evidence-based approaches to HS to ensure maximal consistency and use of high-quality approaches.
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Buxton, Derbyshire SK173JN, UK, d.fishwick@sheffield.ac.uk david.fishwick@hsl.gsi.gov.uk.
authors.forename: D
authors.initials: D
authors.lastname: Fishwick
authors.affiliation: Health and Safety Executive, Redgrave Court, Bootle, Merseyside L20 7HS, UK.
authors.forename: D
authors.initials: D
authors.lastname: Sen
authors.affiliation: Health and Safety Executive, Redgrave Court, Bootle, Merseyside L20 7HS, UK.
authors.forename: P
authors.initials: P
authors.lastname: Barker
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Buxton, Derbyshire SK173JN, UK.
authors.forename: A
authors.initials: A
authors.lastname: Codling
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Buxton, Derbyshire SK173JN, UK.
authors.forename: D
authors.initials: D
authors.lastname: Fox
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Buxton, Derbyshire SK173JN, UK.
authors.forename: S
authors.initials: S
authors.lastname: Naylor
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D013663:Teaching / Q000592:standards
chemical_list: D000395:Air Pollutants, Occupational
keywords: Flour; health surveillance; industry; occupational asthma; wood.