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Different reporting patterns for occupational diseases among physicians: a study of French general practitioners, pulmonologists and rheumatologists

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International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

Physicians can play an important role in the reporting of occupational diseases (ODs), which are still under-reported in many countries. We aimed to identify physicians’ difficulties in recognizing and reporting ODs and to study the characteristics of the physicians that do report ODs.

Methods

We conducted a telephone study in 2006–2007 among general practitioners (GPs), pulmonologists and rheumatologists in south-eastern France, concerning their knowledge, attitudes and practice in occupational health. Simple and multiple logistic regressions were performed to study factors associated with the issue of medical certificates for the claim process.

Results

Three hundred and ninety-one GPs, 95 pulmonologists and 96 rheumatologists participated. GPs reported significantly less often than specialists that they questioned their patients on past occupational exposure. They more frequently reported difficulties in identifying the occupational origin of diseases, and lack of knowledge on the OD reporting system. Issue of medical certificates for OD reporting was significantly more frequent among specialists than among GPs, among physicians considering that ODs are a public health problem, among those acquainted with the forms required to establish certificates, using internet to obtain information, having trade union activities, or having contact with occupational physicians (OPs).

Conclusion

Initial and continuing training should be developed to encourage physicians, in particular GPs, to question patients on their working conditions and to become better acquainted with claim procedures. Physicians should also be provided with tools for identification of ODs that are suited to their practices, and collaboration with OPs should be fostered.

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Acknowledgments

Funding provided by the Ministry of Employment, Labor and Social Cohesion, Direction of Work Relations, French Agency for Environmental and Occupational Health Safety (AFSSET)/French Institute for Public Health Surveillance: coming under the tender for the “ Santé et Travail” research project 2004 (no grant number).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. INSERM, U912 (SE4S), Marseille, France

    Sandrine Arnaud, S. Cabut, A. Viau & P. Verger

  2. IRD, UMR-S912, Université Aix Marseille, Marseille, France

    Sandrine Arnaud, S. Cabut, A. Viau & P. Verger

  3. ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France

    Sandrine Arnaud, S. Cabut, A. Viau & P. Verger

  4. Grand Conseil de la Mutualité-Mutuelles de Provence, Marseille, France

    A. Viau

  5. Laboratoire de Psychologie Sociale, UPRES EA 849, Université Aix-Marseille, Aix-en-Provence, France

    M. Souville

Authors
  1. Sandrine Arnaud
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  2. S. Cabut
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  3. A. Viau
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  4. M. Souville
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  5. P. Verger
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Corresponding author

Correspondence to Sandrine Arnaud.

Appendix

Appendix

Sociodemographic characteristics:

Gender

Age

Professional characteristics:

Year of graduation

Place of practice

Mean daily number of consultations or visits

Uses internet for medical matters: no, yes in the workplace, yes at home

Trade union activities (yes/no)

Variables relating to knowledge

Continuing medical education in the field of occupational health in the preceding 5 years (yes/no)

Already acquainted with OD medical certificates (yes/no)

Knows that the patient must fill in the OD claim form (yes/no)

Variables relating to attitudes and opinions

Thinks that occupational diseases represent a public health problem in his (her) practice area (yes/no)

Feels able to answer patients’ questions about occupational health (yes/no)

Thinks that occupational disease detection is part of his/her role (totally disagree, partially disagree, partially agree, totally agree)

Thinks that completing occupational disease medical certificates is part of his/her role (totally disagree, partially disagree, partially agree, totally agree)

Considers the barriers to reporting occupational diseases are

  • difficulty identifying the occupational origin of a disease (totally disagree, partially disagree, partially agree, totally agree)

  • the lack of time (totally disagree, partially disagree, partially agree, totally agree)

  • the fact that it is not a medical act (totally disagree, partially disagree, partially agree, totally agree)

  • the poor remuneration of initial medical certificates (totally disagree, partially disagree, partially agree, totally agree)

  • the lack of knowledge of administrative procedures (totally disagree, partially disagree, partially agree, totally agree)

  • the lack of knowledge of reporting criteria (totally disagree, partially disagree, partially agree, totally agree)

  • the complexity of the lists of OD qualifying for compensation (totally disagree, partially disagree, partially agree, totally agree)

  • the fear of repercussions on the patient’s job and social situation (totally disagree, partially disagree, partially agree, totally agree)

  • difficulties in obtaining recognition for ODs (totally disagree, partially disagree, partially agree, totally agree)

  • the fear of being manipulated or used by the patient (totally disagree, partially disagree, partially agree, totally agree).

Variables relating to practice

Asks questions about past exposure (never, sometimes, often, very often)

Number of occupational disease medical certificates issued in the past 5 years

Has had patients who refused OD notification (no never, yes once, yes several times)

Has already contacted occupational physicians for suspected occupational disease (never, sometimes, often, very often)

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Arnaud, S., Cabut, S., Viau, A. et al. Different reporting patterns for occupational diseases among physicians: a study of French general practitioners, pulmonologists and rheumatologists. Int Arch Occup Environ Health 83, 251–258 (2010). https://doi.org/10.1007/s00420-009-0457-y

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  • DOI: https://doi.org/10.1007/s00420-009-0457-y

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