Work aggravated asthma in Great Britain: a cross-sectional postal survey.

OBJECTIVE: Work aggravated asthma (WAA), asthma made worse by but not caused by workplace exposures, can have a negative impact on personal, social, financial and societal costs. There is limited data on prevalence levels of WAA in Great Britain (GB). The objective of this study was to estimate the prevalence of WAA in GB, and to assess its potential causes.Materials and methodsA cross-sectional postal questionnaire study was carried out. A total of 1620 questionnaires were sent to three populations of adults with asthma. The questionnaire recorded; demographic details, current job, self-reported health status, presence of asthma and respiratory symptoms, duration and severity of symptoms and medication requirements. Questions relating to work environment and employers' actions were included, and each participant completed an assessment of health-related quality of life using the EuroQol Research Foundation EQ-5D. RESULTS: There were 207 completed questionnaires; response rates were 6% primary care, 45% secondary care and 71% Asthma UK. This represented a 13% overall response rate. Self-reported prevalence of WAA was 33% (95% CI 24.4-41.6%). In all, 19% of workers had changed their job because of breathing problems. Workers with WAA reported higher levels of work-related stress. Quality of life using the EQ-5D utility index was lower in those with WAA. CONCLUSION: WAA is a common problem in asthmatics in GB. This result is in keeping with international prevalence rates. Further research could assist the understanding of the most significant aggravants to asthma at work and help define appropriate interventions by workplaces.

COPD causation and workplace exposures: an assessment of agreement among expert clinical raters.

BACKGROUND: Although occupational exposure is a known risk factor for Chronic Obstructive Pulmonary Disease (COPD), it is difficult to identify specific occupational contributors to COPD at the individual level to guide COPD prevention or for compensation. The aim of this study was to gain an understanding of how different expert clinicians attribute likely causation in COPD. METHODS: Ten COPD experts and nine occupational lung disease experts assigned occupational contribution ratings to fifteen hypothetical cases of COPD with varying combinations of occupational and smoking exposures. Participants rated the cause of COPD as the percentage contribution to the overall attribution of disease for smoking, occupational exposures and other causes. RESULTS: Increasing pack-years of tobacco smoking was associated with significantly decreased proportional occupational causation ratings. Increasing weighted occupational exposure was associated with increased occupational causation ratings by 0.28% per unit change. Expert background also contributed significantly to the proportion of occupational causation rated, with COPD experts rating on average a 9.4% greater proportion of occupational causation per case. CONCLUSION: Our findings support the notion that respiratory physicians are able to assign attribution to different sources of causation in COPD, taking into account both smoking and occupational histories. The recommendations on whether to continue to work in the same job also differ, the COPD experts being more likely to recommend change of work rather than change of work practice.

Health and safety inspection of hairdressing and nail salons by local authority environmental health practitioners.

The objective of the study described in this article was to provide environmental health practitioners (EHPs) with an evaluation of the levels of understanding of, and compliance with, health and safety legislation in hairdressing and nail salons. EHPs carried out a series of inspections of 205 salons in a large British city, consisting of a site assessment and an assessment of employee knowledge of relevant regulations, including those relating to control of exposure to hazardous substances. Two-fifths of senior salon employees understood Control of Substances Hazardous to Health (COSHH) assessments and could provide evidence of their completion. Most employees had been trained and made aware of the health hazards associated with carrying out their work and took suitable precautions to protect themselves and their clients. The results suggest that senior employees within the salons sampled, have knowledge of the risks to health and have been taking measures to control these risks. Initiatives such as the Health and Safety Executive's (in collaboration with local authorities and the hairdressing industry) "Bad Hand Day?" campaign and sector-specific COSHH essentials guidance help raise awareness levels and aim to support good control practice in salons.