Toronto • May 28-29, 2010 • Student Day and Workshops: May 27
Program > Friday > 15:15 > Session symposium. Symposium: Interdisciplinary occupational health practice: A case study
Paper: Physician practice patterns and barriers to practice with a focus on occupational diseases
Author(s) and Affiliation(s):
D Linn Holness
Dalla Lana School of Public Health and Department of Medicine, University of Toronto; Department of Occupational and Environmental Health at St Michael's Hospital; Keenan Research Centre of the Li Ka Shing Knowledge Institute at St Michael's Hospital
Day/Time: Friday at 15:15
Room: Giovanni Room, 2nd Floor
Objectives:
Occupational diseases are often under-recognized and under-reported. While there is continuing evidence that supports poor occupational history taking by physicians, there is less information about practice related to specific occupational diseases and barriers to recognition and reporting of occupational disease. The purpose of two recent studies was to explore physician practice patterns and barriers to practice with respect to three occupational diseases: occupational asthma, occupational contact dermatitis and occupationally related lung cancer.
Methods:
Two studies were conducted. The first was a survey of respirologists, dermatologists and family physicians in Ontario that collected information related to their practice, in particular that of occupationally related problems, and the barriers and facilitators to recognizing and reporting occupationally related disease.1,2 The second study was a feasibility study focused on occupationally related lung cancer that involved interviews with health-care practitioners in lung cancer clinics regarding occupational history taking and barriers to recognition and reporting.
Results:
Survey results found time constraints and lack of knowledge as barriers to taking an occupational history. Reasons for referral to specialists include lack of expertise, testing facilities and knowledge about WSIB, time constraints and inadequate re-imbursement, while lack of access to specialists is a barrier for referral. The lung cancer clinic interviews identified time constraints, lack of knowledge, complexity of the WSIB system and lack of easy referral routes to occupational medicine resources as barriers to recognition and reporting while they noted patient completed exposure questionnaire, clear and simple referral criteria and availability of occupational medicine resources as possible facilitators.
Conclusions:
Both studies identify key barriers to physician recognition and reporting of occupational disease. Methods to address address the barriers need to be developed and tested to improve the recognition and reporting of occupational disease.
References:
Supported by research grants from WSIB Research Advisory Council (#02036) and Worksafe BC
1. Holness DL, Tabassum S, Tarlo SM, Liss G, Silverman F, Manno M. Dermatologist and family physician practice patterns for occupational contact dermatitis, Australas J Dermatol 2007;48, 22-27.
2. Holness DL, Tabassum S, Tarlo SM, Liss G, Silverman F, Manno M. Pulmonologist and family physician practice patterns for occupational lung disease. Chest 2007;132:1526-1531.
