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The management of work-related asthma guidelines: a broader perspective.

ABSTRACT: The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message of these guidelines is that the management of work-related asthma can be considerably optimised based on the present knowledge of causes, risk factors, pathomechanisms, and realistic and effective interventions. To reach this goal we urgently require greatly intensified primary preventive measures and improved case management. There is now a substantial body of evidence supporting the implementation of comprehensive medical surveillance programmes for workers at risk. Those workers who fail surveillance programmes need to be referred to a clinician who can confirm or exclude an occupational cause. Once work-related asthma is confirmed, a revised risk assessment in the workplace is needed to prevent further cases. These new guidelines confirm and extend already existing statements and recommendations. We hope that these guidelines will initiate the much-needed research that is required to fill the gaps in our knowledge and to initiate substantial improvements in preventative measures.

SUBMITTER: Baur X

PROVIDER: S-EPMC9487296 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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The management of work-related asthma guidelines: a broader perspective.

Baur Xaver X Aasen Tor Brøvig TB Burge P Sherwood PS Heederik Dick D Henneberger Paul K PK Maestrelli Piero P Schlünssen Vivi V Vandenplas Olivier O Wilken Dennis D

European respiratory review : an official journal of the European Respiratory Society 20120601 124

The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message ...[more]

PMID: 22654084

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Project description:BackgroundAdverse psychosocial working conditions-in particular poor job decision latitude and poor social support at work-may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with (2) asthma morbidity.MethodsA total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate = 29.3%). Job decision latitude and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four asthma self-management behaviours were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regression analyses to calculate odds ratios with 95% CIs.ResultsLow job decision latitude and low social support were significantly associated with poorer trigger avoidance (odds ratios ≥ 2.09) and poorer acute symptom management (odds ratios ≥ 2.29); low social support was further related to significantly less communication (odds ratio = 2.82). Low job decision latitude and low social support were also associated with significantly poorer asthma control (odds ratios ≥ 1.95) and poorer asthma-specific quality of life (odds ratios ≥ 2.05). The relationships with asthma morbidity were attenuated after adjustment for the four asthma self-management behaviours (odds ratios ranging from 1.1 to 1.9).ConclusionsAdverse psychosocial working conditions are associated with poorer asthma self-management behaviour at work and with increased asthma morbidity. The latter association may be mediated by asthma self-management behaviour.Trial registration German Clinical Trials Register, registration number: DRK S00011309, date of registration: 22.12.2016.

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Project description:IntroductionThroughout the COVID-19 pandemic, two ICU triage guidelines were developed in the Netherlands-the Pandemic Guideline and the Guideline Code Black-ostensibly to tackle the threat of absolute care scarcity. Healthcare guidelines are generally based on evidence and prescribe what healthcare professionals should do in certain situations. We used the institutional work perspective, focusing on the human agency to create, maintain, and/or disrupt institutional structures, to study the development of these guidelines and observed that they did a lot more than just offering guidance to healthcare professionals. By including the Actor Network Theory (ANT) perspective on materiality's agency in our theoretical lens, we show how guidelines, as a materiality-a non-human artefact-interact with human actors and as such shape and are shaped by the social context.Methods17 online documents were analyzed. This analysis resulted in a timeline of events, which was used to identify key actors in the guideline development process. We included 12 purposely sampled respondents for semi-structured interviews. Interview transcripts were thematically coded.ResultsDuring their development, the guidelines played a role in diverse forms of institutional work performed by a variety of stakeholders to: 1) strengthen the medical profession of intensivists; 2) control the medical profession; 3) gain support for the actions needed; and 4) protect the medical profession. In turn, institutional work performed by these stakeholders also shaped the guidelines, indicating the two-sidedness of the interaction between human actors and materiality in the healthcare context.ConclusionsThis case study shows how guidelines as a materiality and human actors interact and influence each other in multiple ways, resulting in institutional work and thus shaping two institutions: the guidelines and healthcare professions. We found that a materiality does not stand on its own but influences and shapes institutional work in relation to human actors. By studying the development, implementation, and use of the guidelines, we gained more empirical insights into the impact materiality can have on the social context of healthcare and how this can influence existing institutional environments.

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The management of work-related asthma guidelines: a broader perspective.

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The management of work-related asthma guidelines: a broader perspective.

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