A mixed-methods study to evaluate the influence of bio-psycho-social and cultural factors on the presence of work-exacerbated asthma

Clinical Research Results Abstract Research Idea Abstract Research questionsWhat is the prevalence of work-exacerbated asthma in a primary care population of working age asthmatics?What is the relationship between work-exacerbated asthma symptoms and physical, psycho-social and workplace cultural factors?What are the experiences and beliefs around potential triggers of people with work-related symptoms but based in low-level inhalational exposure occupations?BackgroundWork-exacerbated asthma (WEA) is common, affecting 1 in 4 asthmatics. WEA substantially impacts individual health, work life and society. Some workers in jobs with low exposure to airway pollutants still report work-related asthma symptoms. We hypothesize that asthma symptoms may be related to other psycho-social and cultural factors.Possible methodologyWe will conduct a survey of employed asthmatics and in-depth interviews with those having work-related symptoms who work in settings with low-level inhalational exposures. We will recruit 650 asthmatics aged 16-65yrs from 15 English primary care practices, and collect data on demographics, asthma control, quality of life, illness perception, anxiety and depression, occupational role, work exposures, work performance (absenteeism, presenteeism) and job satisfaction. We will use a job-exposure matrix to determine whether each occupation is associated with high/medium or low exposure to inhaled pollutants. WEA diagnosis will be based upon work-relatedness of symptoms and objective measures of exacerbation (sickness absence, treatments). Further analysis of this quantitative data, with Framework Method analysis of qualitative interviews, and a health economic analysis describing productivity costs, will investigate the role of cultural and psycho-social factors on work-related symptoms in those with low-level exposures.Questions to discussWhat other psycho-social and cultural factors could be included in the questionnaire?How best to define WEA using the data from primary care practices?Framework Method or thematic analysis would be appropriate for qualitative analysis?What health economic analysis would be suitable, and how would this influence the questionnaire contents? Service Development & Evaluation Abstract Declaration of Interest This study is funded by the Colt Foundation. References and Clinical Trial Registry Information