Understanding the Patient Journey for Occupational Asthma

The Centre for Workplace Health has been undertaking a programme of work to understand the process of being diagnosed with a specific occupational condition, namely occupational asthma. We have worked with patients, clinicians, professional bodies and legislators to gather information that is now helping us to identify strategies that will both prevent the condition occurring, and reduce the number of working days lost once an individual develops the condition.

Figure 1. The stages along the patient journey for occupational asthma

In workplaces where susceptible individuals are exposed to materials that can cause asthma, there is a period of time when they don't experience any symptoms, even though they are developing the condition. The longer exposure continues during this time the more likely it is that they will start to experience the early symptoms of the condition. However, if exposure stops during this period, the condition may never develop.

Once they have the condition, then a number of decision points arise along their journey (as shown in Figure 1), and the length of time it takes each decision to be made will affect both their prognosis and the number of working days that they may loose as a result of developing the condition.

Figure 2. The consequences of the current UK position following our research to understand the patient journey

For example, from our work we know that on average it takes GPs just over 4 years from the initial identification of symptoms by the individual to refer the case on to a specialist hospital doctor. In addition, it will take about five years before an individual appears in the national surveillance scheme for the condition (SWORD) as a result of this work we have identified a number of issues that need to be addressed in order to increase the prospect of preventing the condition, and to reduce the number of working days lost once the condition develops in susceptible individuals. These issues are summarised in Figure 3.

Figure 3. The issues identified from the investigation of the patient journey for occupational asthma

As a result, a programme of activities are now underway to address some of the issues identified, with the aim of helping to contribute to the UK National target to reduce incident cases of occupational asthma by 30% by 2010. For example, the Centre coordinates groups of occupational respiratory disease specialist in the UK (GORDS) and internationally (iGORDS) with the aim of producing a national standard of care for the condition, agreed diagnostic criteria and consistency of reporting to the UK surveillance scheme. Some of these activities are summarised in Figure 4.

Figure 4. Activities coordinated by the Centre for Workplace Health that will help to contribute to UK targets

Further Information

Contact the Centre by telephone (+44) 01298 218447 or email cwh@hsl.gov.uk.