Use of objective testing in the diagnosis of work-related asthma by physician specialty

Ann Allergy Asthma Immunol. 2006 Oct;97(4):546-50. doi: 10.1016/S1081-1206(10)60948-9.

Abstract

Background: Although early and accurate diagnosis of work-related asthma is critical to avoid unnecessary medical, legal, social, and economic consequences, little is currently known about the diagnostic practices of physicians treating workers with work-related asthma.

Objective: To characterize the use of objective diagnostic testing for work-related asthma by physician specialty.

Methods: A cross-sectional, descriptive, comparative evaluation was conducted of 301 workers' compensation claimants with work-related asthma.

Results: A few claimants (36.9%) were treated by specialists in work-related asthma (allergists, pulmonologists, or occupational medicine physicians) either initially or through the course of their claim. Workers with occupational asthma were more likely to have seen a specialist than those with work-aggravated asthma (47.9% vs 23.0%; P < .001). Less than half of the claimants with work-related asthma (43.2%) had received an objective evaluation of pulmonary function, through either pulmonary function testing or testing for reversible airflow limitation, for the evaluation of their work-related asthma. Claimants treated by specialists were significantly more likely to have received diagnostic testing during evaluation of their disease than those treated solely by generalists (82.9% vs 20.0%; P < .001).

Conclusions: The results of this study point to the lack of appropriate diagnostic care received by workers with work-related asthma. Physicians who may have questions about diagnostic procedures should consider referral to a specialist. The development of referral networks for work-related asthma may be warranted and should be explored.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Air Pollutants, Occupational*
  • Asthma / diagnosis*
  • Asthma / immunology*
  • Diagnostic Techniques and Procedures*
  • Humans
  • Medicine / classification*
  • Practice Patterns, Physicians'*
  • Specialization*
  • Treatment Outcome

Substances

  • Air Pollutants, Occupational