abstract: 'Introduction Occupational asthma (OA) accounts for one in six cases of

  adult-onset asthma and is associated with a large societal cost. Many

  cases of OA are missed or delayed, leading to ongoing exposure to the

  causative agent and avoidable lung function loss and poor

  employment-related outcomes. Enquiry about work-related symptoms and the

  nature of work by healthcare professionals (HCPs) is limited, evident in

  primary and secondary care. Potential reasons cited for this are time

  pressure, lack of expertise and poor access to specialists. Aim To

  understand organisational factors and beliefs and behaviours among

  primary HCPs that may present barriers to identifying OA. Methods We

  employed a qualitative phenomenological methodology and undertook 20-45

  min interviews with primary HCPs in West Midlands, UK. We used purposive

  and snowball sampling to include general practitioners (GPs) and

  practice nurses with a range of experience, from urban and rural

  settings. Interviews were recorded digitally and transcribed

  professionally for analysis. Data were coded by hand, and thematic

  analysis was undertaken and determined theoretically until themes were

  saturated. Results Eleven HCPs participated (eight GPs, three nurses).

  Four themes were identified that were considered to impact on

  identification of OA: (1) training and experience, (2) perceptions and

  beliefs, (3) systems constraints, and (4) variation in individual

  practice. OA-specific education had been inadequate at every stage of

  training and practice, and clinical exposure to OA had been generally

  limited. OA-specific beliefs varied, as did clinical behaviour with

  working-age individuals with asthma. There was a focus on diagnosis and

  treatment rather than attributing causation. Identified issues regarding

  organisation of asthma care were time constraints, lack of continuity,

  referral pressure, use of guidelines and templates, and external

  targets. Conclusion Organisation and delivery of primary asthma care,

  negative OA-related beliefs, lack of formal education, and exposure to

  OA may all currently inhibit its identification.'
affiliation: 'Walters, GI (Corresponding Author), Univ Hosp Birmingham NHS Fdn Trust,
  Reg NHS Occupat Lung Dis Serv, Birmingham, W Midlands, England.

  Walters, GI (Corresponding Author), Univ Birmingham, Occupat \& Environm Med, Birmingham,
  W Midlands, England.

  Walters, Gareth, I, Univ Hosp Birmingham NHS Fdn Trust, Reg NHS Occupat Lung Dis
  Serv, Birmingham, W Midlands, England.

  Walters, Gareth, I, Univ Birmingham, Occupat \& Environm Med, Birmingham, W Midlands,
  England.

  Barber, Christopher M., Northern Gen Hosp, Ctr Workplace Hlth, Sheffield, S Yorkshire,
  England.'
article-number: e000938
author: Walters I, Gareth and Barber, Christopher M.
author-email: gareth.walters@heartofengland.nhs.uk
author_list:
- family: Walters I
  given: Gareth
- family: Barber
  given: Christopher M.
da: '2023-09-28'
doi: 10.1136/bmjresp-2021-000938
eissn: 2052-4439
files: []
journal: BMJ OPEN RESPIRATORY RESEARCH
keywords: 'asthma; occupational lung disease; asthma in primary care; asthma

  epidemiology; asthma guidelines'
keywords-plus: RESPIRATORY-DISEASES
language: English
number: '1'
number-of-cited-references: '28'
orcid-numbers: Walters, Gareth/0000-0002-7436-2261
papis_id: fed66a1d37890c21da6b2d4506645db3
ref: Waltersi2021barriersidentifying
times-cited: '0'
title: 'Barriers to identifying occupational asthma among primary healthcare professionals:
  a qualitative study'
type: Article
unique-id: WOS:000688485600002
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '8'
web-of-science-categories: Respiratory System
year: '2021'