Assessment of the potential effects of population changes in attitudes, awareness and beliefs on self-reporting of occupational ill-health

BACKGROUND: It is important to take account of the effects of population changes in attitudes, awareness and beliefs when interpreting temporal trends in self-reported occupational ill-health. Aim To assess how changes in population attitudes, awareness and beliefs have influenced trends in the self-reporting of occupational and other types of ill-health. METHOD: A review of relevant literature was carried out. The criterion for inclusion was that papers must be based on empirical evidence; theoretical discussion papers were included only where empirical examples were included. RESULTS: Several examples were identified where raised awareness of a health problem following intended or unintended publicity was followed by an increase in self-reports of this problem. The magnitude of the increase varied widely according to the situation. One example was identified where self-reports decreased following a publicity programme designed to prevent the occurrence and worsening of the problem in the population. Potential mechanisms identified as influencing changes in self-reporting of ill-health following raised awareness included changes in symptom/illness management, perception of symptoms, tolerance of symptoms, recognition and diagnosis of illness, attribution of illness; social desirability and legitimacy and recall. CONCLUSION: The effects of changes in population attitudes, awareness and beliefs on trends in self-reports of occupational and other illness are difficult to predict for any given situation.