Are Doctors Missing Asthma Caused On The Job

New guidance launched recently in Great Britain calls on doctors to explore the potential job-related causes of asthma when diagnosing patients. An estimated one in six cases of asthma in people of working age is either caused or aggravated by work-related factors.



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



More than 200 substances have been shown to cause occupational asthma; these include plant substances, chemicals and certain metals, with contributing factors such as cigarette smoking making some workers more susceptible.



Dr. Paul Nicholson, lead author of The Guidance, noted,Highlighting the prevalence of occupational asthma is absolutely key, as too often work-related factors are overlooked leading to unnecessary delays in proper investigation and management. When a patient displays signs of asthma, doctors should be enquiring about the patient’s job, the materials they work with, and whether their symptoms improve regularly when away from work.



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.”



Dr. Sian Williams, clinical director of the RCP Health and Work Development Unit, added, “Whilst failing to spot the disease early can hinder a patient’s recovery, an incorrect diagnosis of occupational asthma can also have negative consequences; the worker may be required to change their ways of working, or even their job.. We recommend that doctors assess their patient’s symptoms, history and conduct tests so they can make a fully informed diagnosis.[WCx]



The Guidance, published in the Journal of Clinical Medicine, recommends that doctors seek consent from sufferers to communicate with the employer to advise them of the diagnosis and of the need to protect the patient from further exposure. Also Consult the LexisNexis/Matthew Bender most recent edition of Occupational Injuries and Illnesses for more information on Asthma and other illnesses. 


Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. Contact







Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.


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