Provencher S, Labreche FP, De Guire L, Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE, Quebec, Canada, Occup Environ Med, 1997;54:272-276,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Study evaluated the feasibility of implementing physician based surveillance system of occupational respiratory diseases (PROPULSE) in Quebec. Chest physicians were asked to report suspected new cases of occupational respiratory diseases and assess whether the condition was related to work and then categorise as highly likely, likely, and unlikely. Of the 161 physicians initially approached, 68% participated. Physicians rated 48% of suspected cases as highly likely, 29% as likely, and 20% as unlikely. The most often reported diagnosis was asthma (63%). The high proportion of cases of asthma probably reflects the increasing importance of this disease but may also reflect the different patterns of reporting among physicians with different expertise. The distribution of cases by diagnostic category is quite different between the PROPULSE system and that of the Workers Compensation Board (annual mean number of compensated cases during four year period). Asthma and allergic alveolitis are more frequent in PROPULSE, reactive airways dysfunction syndrome is about the same in both systems, and other diseases are more frequent among compensated cases. The most frequent sensitising agents reported for asthma were the same in both systems (isocyanates, flour, and wood dust). Other main causes were farm and laboratory animals, plastic, additives and rubber and welding fumes Authors conclude that physician based reporting procedure can be implemented as part of surveillance system to supplement data from other sources.

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