Occupational lung disease survey of respiratory physicians in Northern Ireland

Our plain-English summary of Occupational lung disease survey of respiratory physicians in Northern Ireland, by T.F. McKeagney, K. Addley, K. Asanati (Occupational Medicine, 2015).

The study

• Authors: T.F. McKeagney, K. Addley, K. Asanati
• Journal: Occupational Medicine
• Published: 2015;65(9):719-21
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Respiratory physicians are likely to encounter occupational lung disease (OLD) in their daily practice.

Aims: To assess the profile of cases being encountered by general respiratory physicians in Northern Ireland (NI) and determine satisfaction with training, confidence in diagnosis and management of OLD.

Methods: An online survey of all consultant respiratory physicians currently practising in NI. Questions assessed the numbers of new cases seen over the preceding year, case type, satisfaction with specialist registrar training in OLD and degree of confidence in the diagnosis and management of these conditions.

Results: Of the 40 consultants identified, the response rate was 80% (n = 32) with 94% of respondents (n = 30) indicating they had dealt with patients suspected of having occupation-related respiratory symptoms. The most commonly encountered OLDs were pleural plaques (91% of respondents), occupational asthma (88%), asbestosis (84%), non-asbestosis pulmonary fibrosis (76%), hypersensitivity pneumonitis (67%) and mesothelioma (66%). Just over one third of consultants (36%, n = 10) indicated a lack of confidence in diagnosis and management of OLD with almost half (48%) dissatisfied with OLD training as a registrar and a further 78% (n = 25) indicating they would value additional training in OLD as a consultant.

Conclusions: The majority of respiratory consultants in NI encountered OLD in their day to day practice and half were dissatisfied with their specialist registrar training in OLD and express a lack of confidence in the diagnosis and management of these conditions. This highlights the need for additional training at both registrar and consultant level.

© The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: [email protected].

In plain English

This was an online survey of consultant respiratory (lung) physicians in Northern Ireland, carried out as a service evaluation. Of 40 consultants identified, 32 responded (80%). They were asked roughly how many patients they had seen in the last year with lung conditions they felt had been caused or worsened by workplace exposure. They were also asked how satisfied they were with their training and how confident they felt. Ninety per cent had investigated or treated patients with suspected work-related symptoms in the preceding year. Pleural plaques were the most commonly encountered condition (91% of respondents), followed by occupational asthma (88%) and asbestosis (84%). Sixty-six per cent had encountered mesothelioma. Forty-eight per cent were dissatisfied with their specialist registrar training in occupational lung disease, and 78% said they required additional training. Thirty-six per cent reported a lack of confidence in diagnosing and managing these conditions. The authors concluded that this highlights the need for additional training at both registrar and consultant level. They noted that the number of doctors was small and that case numbers were recall estimates, potentially subject to bias. Some figures differ between sections of the article.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Online questionnaire survey (service evaluation) of physicians
• Who was studied: Consultant respiratory physicians in Northern Ireland: 40 identified, 32 responded (80%). Of the respondents, 30 were NHS-based and 2 were retired from NHS practice and working in private and/or medicolegal practice.
• Exposure: No specific exposure was measured. Consultants estimated how many patients they had seen in the last year with conditions they felt had been caused or worsened by workplace exposure. The conditions included pleural plaques, diffuse pleural thickening, asbestosis, mesothelioma, lung cancer (excluding mesothelioma), asthma and others.
• Main results:
  • 90% of responding consultants had investigated or treated patients with suspected work-related symptoms in the preceding year.
  • Pleural plaques were the most commonly encountered occupational lung disease, reported by 91% of respondents.
  • Other conditions encountered, as a percentage of respondents: occupational asthma 88%, asbestosis 84%, non-asbestosis pulmonary fibrosis 76%.
  • Mesothelioma had been encountered by 66% of respondents.
  • 48% of consultants expressed dissatisfaction with their specialist registrar training in occupational lung disease.
  • 78% of consultants indicated that they required additional training.
  • 36% of consultants indicated a lack of confidence in diagnosing and managing occupational lung disease.
  • Only 25% of respondents had used computer software analysis in diagnosing cases of occupational asthma.
• The authors' conclusion: The authors concluded that the findings highlight the need for additional training in occupational lung disease at both registrar and consultant level.
• Limitations the authors state:
  • The authors noted that the number of doctors surveyed (32) was small, although they considered the response rate good.
  • The authors noted that the numbers of conditions encountered were recall estimates and potentially subject to bias.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease, Pleural Plaques, Pulmonary Fibrosis, Pneumonitis, Mesothelioma.

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