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Occupational asthma
S158 Occupational asthma; referral patterns from primary care in the UK
  1. J L Hoyle1,
  2. L Hussey2,
  3. R Agius2
  1. 1North Manchester General Hospital, Manchester, England, UK
  2. 2Centre for Occupational & Environmental Health, The University of Manchester, Manchester, England, UK

Abstract

Introduction and Objectives Occupational asthma is the commonest reported occupational lung disease in the UK1.The British Occupational Health Research Foundation (BOHRF)2 guidelines 2010 recommend that ‘all family practices be able to screen for occupational asthma, and have a plan for further management’. The standards of care for occupational asthma3 recommend ‘early referrals to a specialist with an interest in occupational asthma if such a diagnosis is suspected’. This referral should take place ‘after occupational asthma is screened for before important life decisions are made’. (SIGN guidelines4). Very little is known about the proportion of cases that are referred on to clinical specialists once identified.

Methods The Health & Occupation Reporting network in General Practice (THOR-GP) at the University of Manchester, collects work-related ill-health data between 250 and 300 GPs trained to diploma level in occupational medicine. Cases with a diagnosis of occupational asthma reported in 2006–2009 were divided into subgroups by their causative agent. Cases referred to a hospital specialist were compared to those not referred.

Results In 2006–2009, GPs reported 4902 cases of work-related ill-health, of which 115 (2%) were reports of respiratory disease. 33 were diagnosed with asthma, 6 were referred to a hospital specialist (Abstract S158 Figure 1). The cases not referred included workers exposed to a variety of known asthmagens.

Abstract S158 Figure 1

Agents attributed to asthma cases referred to hospital specialists THOR-GP 2006–2009.

Conclusion Despite national recommendations, these data show that the majority of cases suspected as having occupational asthma are not referred to hospital specialists from primary care. It is not known if the lack of referral affects outcome with regards to disease prognosis, disability or employment status.

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