This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK.

A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure.

Participation rates were 42% for the main part of the study. Less than half of consultants specifically reported they would ask whether symptoms improved away from work, and just over a third mentioned examining the patient. All of those interviewed recommended a chest X-ray, and 98% simple spirometry. Eighty-six per cent suggested measurement of serial peak flows, recorded for between 2 and 8 weeks, with measurements taken half-twelve hourly. Less than half advocated a specific flour allergy test, and almost one-quarter (23%) would not perform any immunological test at all. Once a diagnosis of occupational asthma was confirmed, less than two-thirds of those interviewed commented they would recommend some form of exposure reduction, and only 28% specifically stated they would offer compensation advice.

The diagnosis of occupational asthma by general respiratory physicians within the UK lacks standardisation, and in some cases falls short of evidence-based best practise.