Prevalencia de asma relacionada con el trabajo y su impacto en atención primaria de salud / Prevalence of Work-Related Asthma and its Impact in Primary Health Care

Fundamento y objetivo: Conocer la prevalencia de asma ocupacional (AO) y de asma exacerbada en el trabajo (AET) entre los pacientes diagnosticados de asma en la atención primaria (AP) de salud. Conocer el impacto en AP debido al infradiagnóstico y la no derivación del AO a la mutua laboral. Pacientes y método: Estudio descriptivo, transversal y multicéntrico, realizado en pacientes entre 16 y 64 años diagnosticados de asma en la historia clínica, que estuvieran trabajando o hubieran trabajado, y asignados a cualquiera de los 16 equipos de AP de un sector sanitario. Basándose en las respuestas del cuestionario cumplimentado en la visita del estudio, que contenía una revisión exhaustiva de todas las etapas laborales del sujeto, un experto en asma laboral clasificaba a los asmáticos en 3 categorías: AO, AET o asma común (AC). Resultados: De los 368 pacientes que cumplimentaron el cuestionario se obtuvo una prevalencia de AO del 18,2% (25% en hombres y 14,6% en mujeres, p = 0,046) y 54 pacientes (14,7%) fueron clasificados como AET; así, el total de pacientes con asma relacionada con el trabajo (ART) resultó ser el 32,9%. Los pacientes con ART realizaron más bajas laborales que los pacientes con AC (p < 0,001). Conclusiones: Se obtiene una elevada prevalencia de ART atendida por la AP. Hay una baja sospecha por parte de la AP de ART

Background and objective: To determine the prevalence of occupational asthma (OA) and workexacerbated asthma (WEA) among asthmatic patients diagnosed in Primary Health Care (PHC). To analyze the impact at PHC level caused by under-diagnosis and inappropriate referral of OA. Patients and methods: A descriptive, cross-sectional multicenter study in patients aged between 16 and 64 years diagnosed with asthma, according to their medical record; all were working or had worked, and were assigned to one of 16 PHCcenters inahealthcare district.Based onthe responses to the questionnaire completed at the study visit, which included a thorough review of the subject’s entire working history, patients were classified into three categories by an expert in occupational asthma: OA, WEA or common asthma (CA). Results: Three hundred and sixty-eight patients completed the questionnaire. The prevalence of OA was 18.2% (25% in men and 14.6% in women, P = .046), and 54 patients (14.7%) were classified as WEA. The proportion of patients with work-related asthma (WRA) was therefore 32.9%. Asthmatic patients with WRA took more sick leave than CA patients (P < .001). Conclusions: A high prevalence of WRA was found, mostly treated in PHC. Under-diagnosis of WRA is widespread in PHC

Prevalence of Work-Related Asthma and its Impact in Primary Health Care.

BACKGROUND AND OBJECTIVE: To determine the prevalence of occupational asthma (OA) and work-exacerbated asthma (WEA) among asthmatic patients diagnosed in Primary Health Care (PHC). To analyze the impact at PHC level caused by under-diagnosis and inappropriate referral of OA. PATIENTS AND METHODS: A descriptive, cross-sectional multicenter study in patients aged between 16 and 64years diagnosed with asthma, according to their medical record; all were working or had worked, and were assigned to one of 16 PHC centers in a healthcare district. Based on the responses to the questionnaire completed at the study visit, which included a thorough review of the subject's entire working history, patients were classified into three categories by an expert in occupational asthma: OA, WEA or common asthma (CA). RESULTS: Three hundred and sixty-eight patients completed the questionnaire. The prevalence of OA was 18.2% (25% in men and 14.6% in women, P=.046), and 54 patients (14.7%) were classified as WEA. The proportion of patients with work-related asthma (WRA) was therefore 32.9%. Asthmatic patients with WRA took more sick leave than CA patients (P<.001). CONCLUSIONS: A high prevalence of WRA was found, mostly treated in PHC. Under-diagnosis of WRA is widespread in PHC.

Prevalence of Work-Related Asthma in Primary Health Care: Study Rationale and Design.

BACKGROUND: Occupational Asthma (OA) is the most frequent origin of occupational respiratory diseases in industrialized countries and accounts for between 5% and 25% of asthmatic patients. The correct and early diagnosis of OA is of great preventive and socio-economic importance. However, few studies exist on OA's prevalence in Catalonia and in Spain and those affected are mainly treated by the public health services and not by the occupational health services, which are private. OBJECTIVE: To determine the prevalence of OA in patients diagnosed with asthma in the Primary Healthcare system and to evaluate the socio-economic impact of OA in the Primary Healthcare system. METHODS/DESIGN: We will carry out an observational, transversal and multi-center study in the Primary Healthcare Service in the Barcelona region (Catalonia, Spain), with 385 asthmatic workers aged between 16 and 64 who are currently working or have been working in the past. We will confirm the asthma diagnosis in each patient, and those meeting the inclusion criteria will be asked to answer a questionnaire that aims to link asthma to the patient's past employment history. The resulting diagnosis will be of either occupational asthma, work-aggravated asthma or common asthma. We will also collect socio-demographic information about the patients, about their smoking status, their exposure outside of the workplace, their work situation at the onset of the symptoms, their employment history, their symptoms of asthma, their present and past medical asthma treatment, and, in order to estimate the economic impact in the Primary Healthcare system, where they have been attended to and treated. Prevalence will link OA or work-aggravated asthma to the total of patients participating in the study with a asthma diagnosis. DISCUSSION: The results will show the prevalence of OA and work-aggravated asthma, and shall provide valuable information to set out and apply the necessary personal and technical measures, either in the public or in the occupational health services. No studies evaluating the costs generated by the OA in the Primary Healthcare system have been carried out.