Airway Responsiveness Measurements in Asthmatic Recruits to Emergency Services

P5 Table 1 n Current symptoms Preventer inhaler Median FEV1 Definite asthma 16 8 (50%) 12 (75%) 106% Equivocal asthma 6 1 (17%) 5 (83%) 109% Normal 18 6 (33%) 10 (55%) 107% REFERENCE 1. Stenton SC, et al. Occup Med 1993;43:203e6. P6 WORK-RELATED RESPIRATORY SYMPTOMS IN THE UK; DO PRIMARY CARE PHYSICIANS MISS DIAGNOSTIC OPPORTUNITIES IN OCCUPATIONAL ASTHMA? doi:10.1136/thx.2010.150961.6 J Hoyle, L Hussey, R Barraclough, R Agius. North Manchester General Hospital, Manchester, UK; Centre for Occupational & Environmental Health, The University of Manchester, Manchester, UK Introduction and objectives Occupational lung disease is prevalent and costly. Population-based studies show that up to 20 cases of occupational lung disease per 100 000 workers per year should be identified. The Health and Safety Executive estimates the cost of occupational asthma to our society to be over £1.1 billion for each 10 year period. The prognosis of these individuals is better if they are removed from exposure quickly; however, this policy leads to unnecessary job loss in caseswhere the diagnosis iswrong. Little is known about the number ofworkerswhopresent to primary carewithwork-related symptoms, or what proportion of these are referred for hospital specialist advice once a work-related element has been identified. Methods The Health & Occupation Reporting network in General Practice (THOR-GP) at the University of Manchester, collects workrelated ill-health data from between 250 and 300 GPs trained to diploma level in occupational medicine. Cases of undiagnosed respiratory disease, reported as unspecified work-related respiratory symptoms between 2006 and 2009 were retrospectively identified. The cases were subdivided into exposure (if known) and categorised as referred if sent to a hospital specialist for further investigation. Results In 2006e2009 GPs reported 4902 cases of work-related illhealth, of which 115 (2%) were reports of respiratory disease. 27 cases of non-specified work-related respiratory illness were identified. Only 26% (7/27) were referred for a specialist opinion despite uncertainty of diagnosis. Of those not referred, the majority (17/20) were exposed to known asthmagens as illustrated in Abstract P6 Figure 1 (consensus view after exposure review from three occupational/respiratory physicians). Abstract P6 Figure 1 Agents attributed to cases reported with respiratory symptoms referred to hospital specialists.P6 Figure 1 Agents attributed to cases reported with respiratory symptoms referred to hospital specialists. Conclusions More than three quarters of the cases with undiagnosed work-related symptoms identified in primary care were not referred to secondary care for diagnostic clarification. 85% of these cases were exposed to known asthmagens. The lack of diagnosis and/or specialist assessment in these cases may have significant impact on disease prognosis, disability and socio-economic cost to society. P7 OCCUPATIONAL EOSINOPHILIC CONSTRICTIVE BRONCHIOLITIS WITH ASTHMA IN A FOAM CUTTER CAUSED BY SOYA BEAN PRODUCTS doi:10.1136/thx.2010.150961.7 J Hoyle, K Ballance, H Francis, CAC Pickering, RMc Niven. North Manchester General Hospital, Manchester, UK; North West Lung Centre, Wythenshawe Hospital, Manchester, UK Introduction and background Soya bean dust is a recognised cause of asthma. More recently Soya bean has bean used in the Thorax December 2010 Vol 65 Suppl 4 A79 Poster sessions group.bmj.com on September 7, 2017 Published by http://thorax.bmj.com/ Downloaded from