Audit of quality of diagnostic procedures for occupational asthma

Sauni, Riitta; Kauppi, Paula; Helaskoski, Eva; Virtema, Pauliina; Verbeek, Jos

doi:10.1093/occmed/kqn165

Cited by 17 publications

(14 citation statements)

References 15 publications

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“…47 Comparisons of surveys and surveillance have shown that routine screening of exposed workers through occupational health underestimates the frequency of disease. 19 …”

Section: Delayed Diagnosismentioning

confidence: 99%

Occupational Asthma. Current Practice

Szram

2012

Clinical Pulmonary Medicine

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Exposures at work are an often overlooked but important cause of asthma and other airway diseases. Evidence from large population-based studies shows that 1 in 10 cases of asthma occurring, recurring, or worsening in adulthood can be related to occupational factors. The majority of cases are of pre-existing asthma made worse by employment [work-exacerbated asthma (WEA)]. Adults presenting with increased or new asthma symptoms should be carefully assessed so that WEA can be distinguished from true occupational asthma (OA), a disease that is directly caused by a workplace exposure. Airways disease may also arise from toxic exposures to respiratory irritants at work. In most cases, symptoms are self-limiting, but an asthma-like syndrome (irritant-induced asthma) occasionally results. OA and WEA require different diagnostic and management approaches. Key steps required to make a definitive diagnosis of either condition are an awareness of the disease with an associated low threshold of suspicion, time spent acquiring a full and detailed job history followed by carefully considered application of a few simple important diagnostic investigations. A satisfying part of managing OA is the opportunity for cure (provided that the necessary management advice can be implemented), although the socioeconomic consequences-mainly to the patient themselves-can be high.

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“…47 Comparisons of surveys and surveillance have shown that routine screening of exposed workers through occupational health underestimates the frequency of disease. 19 …”

Section: Delayed Diagnosismentioning

confidence: 99%

Occupational Asthma. Current Practice

Szram

2012

Clinical Pulmonary Medicine

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“…Although many consensus practice guidelines on diagnostic procedures have been issued and made widely available over the years-the latest addition being the British Thoracic Society initiative [48••]-they are still insufficiently applied, as shown by audits in Finland [49]. Serial assessment of peak expiratory flows comparing periods at work and away from work has been advocated since 1980 because this approach is superior to two single cross-shift assessments of spirometry (as was recently reconfirmed) [50].…”

Section: Clinical Aspectsmentioning

confidence: 99%

Occupational Rhinitis and Asthma: Where Do We Stand, Where Do We Go?

Castaño

Malo

2010

Curr Allergy Asthma Rep

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This review provides an overview of current and emerging issues regarding occupational rhinitis (OR) and occupational asthma (OA), focusing on studies discussing concepts and results that are relevant to both diseases. OA and OR are conditions that affect the upper and lower airways, are characterized by reduced airway caliber and hyperresponsiveness and by inflammation, and are caused by agents present in the workplace. To explain disease expression, research is moving from the T-helper type 1/type 2 cells paradigm to consider the contribution of diverse alternative pathways such as neural inflammation, a dysfunctional epithelial barrier, and autoimmune mechanisms, among others. Objective assessment of OR and OA has been improved and tested for research and, currently, clinical application. Further developments in the field of OR are expected to lead to more generalized clinical applications, following the example of what has been achieved for OA.

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“…[9][10][11][12] Studies from a range of countries, however, have identified average delays of several years in the patient journey for symptomatic workers, which in part relate to the condition being under-recognised in primary care. [13][14][15][16] National published guidelines for the prevention, The full version of this paper, with online Appendix, is available at www.thepcrj.org …”

Section: Introductionmentioning

confidence: 99%

“…PRIMARY CARE RESPIRATORY JOURNAL www.thepcrj.org [13][14][15][16] which may in part relate to deficiencies in undergraduate and postgraduate occupational training. This is highly relevant for affected workers, since early and accurate diagnosis linked with exposure modification offers the best prognosis, both for health and socioeconomic outcomes.…”

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confidence: 99%

Knowledge and utilisation of occupational asthma guidelines in primary care

Barber

Frank

Walsh³

et al. 2010

Primary Care Respiratory Journal

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Aims: To develop an occupational asthma learning module, which could be used both as an educational tool and to evaluate awareness and usage of clinical guidelines in primary care.Methods: Healthcare professionals were invited to undertake an interactive BMJ Learning module, developed from existing national occupational asthma guidelines. Participants were invited to record immediate post-module feedback, and were also sent an e-mail questionnaire six weeks later to assess the impact of the module.Results: In total 1041 healthcare professionals completed the learning module within the first six months, which was associated with significant improvements in knowledge, and predominantly positive feedback. The e-mail follow-up questionnaire demonstrated improved usage and awareness of national occupational asthma guidelines.Conclusions: Significant barriers remain in ensuring that evidence-based occupational medicine guidelines are adopted in primary care. This project has demonstrated that e-learning offers one method of improving postgraduate medical education in this area, particularly where evidence-based guidelines have already been developed.

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Audit of quality of diagnostic procedures for occupational asthma

Abstract: Although the diagnostic procedures were mostly of sufficient quality, the performance of serial measurements of PEF at the workplace and the time to diagnosis should be substantially improved.

Cited by 17 publications

References 15 publications

Occupational Asthma. Current Practice

Occupational Asthma. Current Practice

Occupational Rhinitis and Asthma: Where Do We Stand, Where Do We Go?

Knowledge and utilisation of occupational asthma guidelines in primary care

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