Occupational asthma – new guidance for doctors when diagnosing patients

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Photo by shawnzrossi via Flickr, under Creative Commons Licence

New guidance published in the Journal of Clinical Medicine at the end of last month has called on doctors to explore the potential job-related causes of asthma when diagnosing patients. The guidance also recommends that doctors seek consent from sufferers to communicate with their employer to advise them of the diagnosis and of the need to protect the employee from further exposure.

According to Asthma UK (a UK charity dedicated to improving the health and wellbeing of those affected by asthma) 5.4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12). Approximately one in six people of working age who develop asthma have occupational asthma, where work has either caused or aggravated their condition.

The guidance, produced by the Royal College of Physicians and funded by NHS Plus, advises hospital doctors to question patients with respiratory problems about their jobs, the materials they work with and whether their symptoms improve when they are away from work. They also need to be aware of those jobs that carry particular risks (e.g. laboratory work, work in the chemical industry, etc.). Doctors are also being urged to not rely solely on the patient’s history but to conduct tests (e.g. peak flow measurements at/away from work and skin-prick tests for allergy to substances that could potentially be causing the illness).

Substances used in a wide range of industries have been shown to cause occupational asthma, including those used in:

  • baking;
  • motor repairs;
  • woodworking;
  • chemical processing;
  • farming;
  • cleaning;
  • textile, plastics and rubber manufacturing;
  • healthcare and dental care.

In order to manage a case of occupational asthma effectively, the condition must be diagnosed quickly and the employee should be protected from further exposure to the cause of the asthma, particularly as a person’s symptoms might be brought on by exposure to extremely low concentrations of a respiratory sensitiseronce they have been sensitised to it (see our guide to respiratory sensitisers on our knowledge base). In order to achieve this, doctors should carry out a full assessment of a patient’s symptoms and history in order to allow for a full diagnosis.

According to Professor John Harrison, Director of NHS Plus:

“About 70% of the UK workforce does not have access to occupational health care. This makes it vital that hospital doctors and respiratory specialists are assessing asthma patients for potential work-related causes and advising appropriate treatment and preventative measures. By following this guidance they will offer their patients the best chance of recovery. The guidelines will benefit all doctors and healthcare professionals caring for people of working age, a long standing goal of NHS Plus.”

Employers who suspect that an employee’s respiratory problems may be occupational asthma, or who are concerned about any other employee health issues, can call the free Health for Work Adviceline on 0800 0 77 88 44.

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