RESUMEN
We studied occupational physicians' (OPs) practices of referrals for imaging of workers occupationally exposed to lung/pleural carcinogens and the factors associated with them. This cross-sectional telephone survey of 379 OPs practicing in Southeastern France showed that 81% of them referred exposed patients for chest radiographs, 33.5% for computed tomography (CT), and 16.1% for neither. Making no referral was positively associated with believing cancer risks are lower in one's own geographic sector than elsewhere and negatively associated with keeping employee risk records up-to-date. Referrals for CT were positively associated with work at in-house occupational health services (OHS), and completing employee exposure histories often/always. Both the OHS type and factors that may shape OPs' awareness of cancer risks in their sector appear to influence imaging referral practices. Occupational physicians would benefit from guidelines clarifying benefits and risks associated with imaging in such patients. An effort to harmonize regulatory provisions and guidelines also appears necessary.
Asunto(s)
Carcinógenos Ambientales/toxicidad , Neoplasias Pulmonares/diagnóstico por imagen , Enfermedades Profesionales/diagnóstico , Exposición Profesional/efectos adversos , Salud Laboral/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Contaminantes Ocupacionales del Aire/toxicidad , Estudios Transversales , Femenino , Humanos , Neoplasias Pulmonares/inducido químicamente , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
We conducted a qualitative survey of 20 occupational physicians (OPs) in southeastern France in 2008 to study their attitudes and practices regarding the prevention of occupational cancers. Occupational physicians' practices regarding occupational cancers centered mainly on prevention. Numerous difficulties impeded these activities: attitudes that minimized the carcinogenic risks by employers and employees, the absence or inadequacy of mandatory risk assessment to identify health hazards, and difficulties in obtaining individual exposure forms, which employers are supposed to complete to identify employees exposed to carcinogens. Other problems were related to the resources available to OPs and the constraints on their time. Finally, some OPs reported that they lacked self-efficacy. The results of this study suggested the need to strengthen OPs' initial training, draft and adopt good practice guidelines for various aspects of their practices, and improve collaborations between OPs and other professionals specialized in the prevention of occupational risks.