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GPs urged to ask about job-related factors in asthma

GPs should check job-related causes of asthma to catch occupational asthma early, say guidelines from the Royal College of Physicians have recommended.

The guideline comes after a recent study estimated one in six cases of asthma in people of working age is aggravated by work-related factors.

The guideline says over 200 substances can trigger occupational asthma – including chemicals, plant extracts and certain metals – and that those working in laboratories, the chemical industry and the veterinary industry are most at risk.

They recommend GPs ask about these triggers before referring patients, and whether symptoms improve on days away from work.

The guidance says: ‘Physicians who assess working adults with asthma need to ask the patient about their job and the materials they work with, and be aware of those that carry particular risks; they should also ask whether symptoms improve regularly on days away from work.’

‘Following a validated diagnosis of occupational asthma, physicians should recommend early avoidance of further exposure, because this offers the best chance of complete recovery.’

‘If appropriate and timely interventions are not taken, the prognosis of occupational asthma is poor, with only approximately one-third of workers achieving full symptomatic recovery.’

Dr Paul Nicholson, lead author of the guidance, published in the Journal of Clinical Medicine, said: ‘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.’

Dr Kevin Gruffydd-Jones, a GP from Wiltshire and a member of the education committee of the Primary Care Respiratory Society, said the guidance highlighted the importance of recognising the condition.

He said: ‘Occupational asthma is something that is under recognised and something which should be caught early, as it can be cured rather quickly.’

Dr Dermot Ryan, a GP in Loughborough and co-author of the British Thoracic Society asthma guidelines, said: ‘If a patient symptom’s are worsened or triggered while in the workplace, there first point of call will be GPs.’

‘If doctors suspect a patient has occupational asthma then they should immediately refer them to a respiratory physician who will be able to deal better with the patient.’

Read the full guidance here