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

Verger, P.; Arnaud, S.; Ferrer, S.; Iarmarcovai, G.; Saliba, M.-L.; Viau, A.; Souville, M.
June 2008
Occupational & Environmental Medicine;Jun2008, Vol. 65 Issue 6, p392
Academic Journal
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% Cl 2.38 to 8.37, for pulmonologists vs GPs), patient's smoking status (OR 3.15; 95% Cl 2.11 to 4.70, for non-smokers vs smokers), physician's workload (OR 1.83; 95% Cl 1.17 to 2.88, for ⩽25 consultations per day vs >25) and role perception (OR 2.00; 95% Cl 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.


Related Articles

  • Influence of patient education on profiles of physician practices. Fiscella, Kevin; Franks, Peter // Annals of Internal Medicine;11/16/99, Vol. 131 Issue 10, p745 

    Determines the influence of the level of education of patients on profiles of physician practices in western New York State. Impact of patient's education on physician performance on patient's physical and mental status; Change in physician rank associated with adjustment for patient's level of...

  • Asbestosis and lobar site of lung cancer. Weiss, W. // Occupational & Environmental Medicine;May2000, Vol. 57 Issue 5, p358 

    Assesses the evidence for the hypothesis that lung cancer has a predilection for lower lobes in industrial workers with asbestosis. Number of reports that were analyzed to collect evidence for the hypothesis; Data related to studies showing lower lobe predominance of lung cancer; Need of more...

  • Asbestos Disease in Family Contacts of Shipyard Workers. Kilsurn, Kaye H.; Lilis, Ruth; Anderson, Henry A.; Thomas Bóylen; Elnsteln, Hans E.; Johnson, Sue-J. S.; Warshaw, Raphael // American Journal of Public Health;Jun85, Vol. 75 Issue 6, p615 

    Radiologic signs of pulmonary asbestos disease were found in 11.3 per cent of 274 wives of shipyard workers who were 20 or more years from initial hiring-on in shipyards in Los Angeles County. Asbestosis was also found in 7.6 per cent of 79 sons and 2.1 per cent of 140 daughters of these...

  • Exploring physician perceptions of the impact of emotions on behaviour during interactions with patients. Kushnir, Talma; Kushnir, Jonathan; Sarel, Amiram; Cohen, Avner H // Family Practice;Feb2011, Vol. 28 Issue 1, p75 

    Background. There is relatively little research on affective influences on physician behaviour, especially on prescribing and referrals. Affects include transitory moods and lasting emotions.Objectives. We explored physician perceptions of the impact of four mood states on perceived rates of...

  • Medical Ethics and Personal Doctors: Conflicts Between What We Teach and What We Want. Levine, Robert J. // American Journal of Law & Medicine;1987, Vol. 13 Issue 2/3, p351 

    Deals with the presuppositions of ordinary people and of the mainstream of American medical ethics about the disposition of doctors towards patients. Hippocrates' injunction to doctor's to treat patients as persons; Contradiction between how patients want their doctors to treat them and the...

  • Iranian Physicians and Patients Attitude toward Truth Telling of Cancer. Zamani, Ahmadreza; Shahsanai, Armindokht; Kivan, Shima; Hematti, Simin; Mokarian, Fariborz // Journal of Isfahan Medical School;8/15/2011, Vol. 29 Issue 143, p1 

    Background: Truth telling is found as one of the most important issues in physician-patient communication and all of the physicians are concerned with it in some way. As disclosure (or truth reticence) would cause ethical or legal problems, this study aimed to assess the attitude of patients and...

  • I love you--don't sue me.  // Modern Healthcare;1/24/2005, Vol. 35 Issue 4, p36 

    Focuses on the celebration of the National Love Your Patients Day pioneered by emergency room physician Scott Diering on February 7, 2005 in the U.S. Perception of patients on doctors' attitudes; Importance of establishing good relations with patients according to Diering; Reaction of Diering...


    In this article, the types of legal relationship between the patient and physician were analyzed. First of all, the approaches of the treatment contract is a type of sui generis contract, service contract and mandate contract were handled. Moreover the details of that approaches, decisions of...

  • The responsibility of the doctor. Havard, John D J. // BMJ: British Medical Journal (International Edition);8/19/89, Vol. 299 Issue 6697, p503 

    Focuses on the standards set by th General Medical Council regarding the relationship between doctors and patient in the United States. Comparison of the directives of American and English Law; Principles underlying the practice; Cases cited in application of the law.


Read the Article


Sign out of this library

Other Topics