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Occupational asthma: are we recognising at risk patients?

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Paul Ellis1 and Gareth Walters1
1Heart of England NHS Foundation Trust, Birmingham, United Kingdom


Occupational aetiology accounts for 1 in 6 cases of new onset adult asthma. Better health and employment outcomes from occupational asthma are achieved with rapid diagnosis and removal from exposure to or avoidance of the causative agent1. Despite this, occupational asthma remains poorly recognized by healthcare professionals, demonstrated previously in UK primary care2. We aimed to determine whether an occupational cause is considered in adult asthmatic patients when attending hospital.

We assessed medical records of 200 working-age adults with asthma symptoms. One hundred patients presented to the emergency department (ED) and a further 100 to the acute medical unit (AMU) at 3 city hospital sites at Heart of England NHS Trust, Birmingham, UK, between April 2015 and November 2016.

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The average age of patients was 33.6 years (28.3 in ED, 38.9 in AMU), 42% of whom were male. Only 26% were asked about their occupation (ED 20%, AMU 31%), 58.8% of whom were employed. Of these, 67% received enquiry about the nature of their work (ED 50%, AMU 75%). Smoking status was not established in 27% of cases (ED 41%, AMU 13%).

The results demonstrate that health care professionals do not routinely assess risk of occupational asthma in working-age adults when not prompted to do so. Re-education of health care professionals and standardisation of admission documentation to include occupation history are proposed ways to tackle this issue.



Source : http://erj.ersjournals.com/content/50/suppl_61/PA4773
Image : https://i.ytimg.com/vi/qWPLw-0OjKU/maxresdefault.jpg



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