Occupational asthma and work-exacerbated asthma: factors associated with time to diagnostic steps.

Chest. 2007 May 15; Santos MS, Jung H, Peyrovi J, Lou W, Liss GM, Tarlo SM. Gage Occupational and Environmental Health Unit, Canada.

Little is known regarding factors associated with the times for patients' first physician visit, first physician suspicion of work-related asthma and final diagnosis, after the onset of work-related asthma symptoms. This study examined individual and work-related factors associated with longer times to these diagnostic milestones among groups with occupational asthma (OA) and work-exacerbated asthma (WEA).

Suspected work-related asthma cases were identified from an occupational lung disease clinic and claimants to the Ontario Workplace Safety and Insurance Board (WSIB)[100 patients each]. Questionnaire administration and chart review were undertaken. Results 80 participants were classified as sensitizer-induced OA and 87 as WEA. For the OA group, risk factors for delay included male sex, being unmarried, low education and lack of awareness of associations of symptoms with work. Other factors included older age, being the sole income earner and lack of knowledge of the Workplace Hazardous Materials Information System (WHMIS) program. For WEA, lower household income, lower education, absence of a Health and Safety Program at work, absence of a union, lack of awareness of OA and of agents at work which could affect asthma significantly increased time to diagnostic milestones. Conclusions
Different factors affect diagnostic milestones for OA and WEA. Findings suggest a need for educational programs for workers at risk of OA and WEA and a need for further primary care physician education on work-related asthma.

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