rss
Occup Environ Med 2008;65:392-397 doi:10.1136/oem.2007.035808
  • Original article

Inequities in reporting asbestos-related lung cancer: influence of smoking stigma and physician’s specialty, workload and role perception

  1. P Verger1,2,
  2. S Arnaud1,
  3. S Ferrer1,
  4. G Iarmarcovai1,
  5. M-L Saliba1,2,
  6. A Viau3,
  7. M Souville4
  1. 1
    Southeastern Health Regional Observatory (ORS PACA), Marseilles, France
  2. 2
    French Institute of Health and Medical Research (INSERM UMR379), Marseilles, France
  3. 3
    Grand Conseil de la Mutualité-Mutuelles de Provence, Marseilles, France
  4. 4
    Aix Marseille University, Laboratoire de Psychologie Sociale, UPRES EA849, Aix-en-Provence, France
  1. Pierre Verger, Observatoire Régional de la Santé PACA, INSERM UMR 379, 23 rue Stanislas Torrents, 13006 Marseille, France; verger{at}marseille.inserm.fr
  • Accepted 28 September 2007
  • Published Online First 10 October 2007

Abstract

Objectives: To study physician barriers to workers’ compensation claims for asbestos-related cancers, focusing on smokers’ stigma and physicians’ speciality and role perception.

Methods: Cross-sectional telephone study of 486 randomly-selected general practitioners (GPs) and pulmonologists in south-eastern France. Standardised questionnaires explored their behaviour, attitudes and practices in the field of occupational health and their responses to a case vignette of a lung cancer patient with long-term occupational asbestos exposure. Randomised subgroups of GPs and pulmonologists heard alternative versions varying only as regards the worker’s smoking status. We studied factors associated with the recommendation that the case vignette patient file a compensation claim with simple and multiple logistic regressions.

Results: The response rate was 64.4 among GPs and 62.5 among pulmonologists. Recommending the filing of an occupational disease claim was significantly associated in multiple logistic regressions with speciality (OR 4.46; 95 CI 2.38 to 8.37, for pulmonologists vs GPs), patient’s smoking status (OR 3.15; 95 CI 2.11 to 4.70, for non-smokers vs smokers), physician’s workload (OR 1.83; 95 CI 1.17 to 2.88, for ≤25 consultations per day vs >25) and role perception (OR 2.00; 95 CI 1.22 to 3.27, for those who considered completing occupational disease medical certificates to be part of their role vs those who did not).

Conclusions: The results of this French study appear applicable to various countries and contexts. To make physicians and especially GPs more aware of occupational health and smoking stigma, officials and educators must give these topics higher priority during initial training and continuing medical education. Tools and equipment that take time constraints into account should be developed and disseminated to help physicians manage occupational diseases.

Footnotes

  • Funding: This study received support from the call for proposals “Health at Work” 2004, of the Ministère de l’emploi, du travail et de la cohésion sociale/Direction des Relations du Travail.

  • Competing interests: None.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All Versions of this Article:
    1. oem.2007.035808v1
    2. 65/6/392 most recent

Responses

  1. Submit a response
  2. No responses published

Social bookmarking

Register for free content


Free sample
 This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of OEM.
View free sample issue >>

Free archive
The full back archive is now available for OEM. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006, back to volume 1 issue 1.
Register to access the free archive >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.