Feasibility of clinicians asking patients about their exposure to occupational hazards: An intervention at five primary care health centres

Kushner R, Kramer DM, Holness DL. Work 2018 60(3):365-384.

Background: Ontario’s occupational health and safety prevention system has identified a need for the systematic collection of occupational exposure data for ongoing surveillance and targeted prevention initiatives.

Objectives: To examine the feasibility of collecting occupational exposure information within a primary care clinical setting.

Methods: Five healthcare centres were recruited. Working patients answered basic occupational exposure questions. Clinicians reviewed the answers with patients. Answers were entered into the patient’s electronic medical records (EMRs). A knowledge broker supported the health centres throughout the trial with background information and linking to occupational expertise. Interviews with administrators and clinicians examined the usefulness of the survey to primary care, the barriers and facilitators, and sought suggestions for sustaining the practice. A cross-case analysis, framed by a conceptual model, was conducted from the feedback.

Results: Themes highlighted the importance of clinician and administrator buy-in, the perceived relevance of occupational exposures to primary care clinicians and the patient population, and the need for clinicians to feel confident about the health impact and relevance of occupational exposures to presenting clinical problems.

Conclusion: Clinicians ask work exposure-related questions when patients have a health concern that the clinicians suspect may be related to a work exposure. No clear clinical purpose for routinely asking exposure questions emerged.