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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2224v1 132/5/1526    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Linn Holness, D Articles by Manno, M. Search for Related Content PubMed PubMed Citation Articles by Linn Holness, D Articles by Manno, M.

PRACTICE PATTERNS OF PULMONOLOGISTS AND FAMILY PHYSICIANS FOR OCCUPATIONAL ASTHMA

Gage Occupational and Environmental Health Unit St Michael's Hospital and University of Toronto

HOLNESSL{at}smh.toronto.on.ca

Abstract

BackgroundThe longer the duration of symptoms of occupational asthma (OA) before diagnosis, the poorer the outcome. Physicians can play a key role in the early recognition of occupational lung diseases including OA. Our objective was to document and compare the practice patterns, barriers and needs for early diagnosis of OA among pulmonologists and family physicians.

MethodsBased on information from the literature and interviews with pulmonologists and family physicians a survey was developed to obtain information on practice patterns. The survey was sent to all pulmonologists and a random sample of 600 family physicians in Ontario.

Results8% of pulmonologists and 7% of family physicians report seeing more than 20 patients a year with occupational lung disease. The majority report taking a workplace exposure history. The most commonly stated barrier to obtaining a workplace exposure history was time constraints. Main reasons for referral to specialists for diagnosis include personal lack of expertise, testing facilities and knowledge about workers' compensation, while lack of timely access to specialists is a barrier for referral. While most physicians identified a need for further education, those that did not identify a need for further occupational respiratory education cited low volume of patients, access to specialists and time constraints as reasons for not wanting further education.

ConclusionsOpportunities are identified to improve health services delivery and educational initiatives for OA, with approaches tailored to each particular physician group.

Key Words: Occupational asthma • Occupational lung disease • Medical education • education needs • occupational history • exposure history • barriers • referral patterns