Ahmad has found a virus in ASTHM.DOC sent with my posting last
week.Oops and sorry. It's my first offence, honest!

Below is the letter in text form and I have re-attached the leaflet
ASTHMLEAF.DOC, which was clean.


Graham Ross

Dear Colleague

Please allow me to introduce myself.  I am Dr Vinod Saksena, a
semi-retired general practitioner in a three doctor practice in St
Helens, Merseyside.

I act as medical consultant to the Allied Lawyers Response Team (ALeRT).
 This is a network of solicitors' offices, one of which is in your area,
who work together to co-ordinate personal injury litigation.  The cases
ALeRT take on all involve some element of public interest, that is to
say that they relate to a risk of injury or illness caused in
circumstances, for example in the workplace or by products, which are
such as that many others may also have been affected.

ALeRT operates on a `hub and spoke' basis with a central unit that
undertakes the general medical and scientific linked legal research and
designs the protocol for, and co-ordinates the running of, the cases
throughout the country, with the member firms dealing with the
individual case aspects.

The project I wish to discuss with you is one concerning Occupational
Asthma.  We all know from our own practice experience the numbers of
patients developing asthma in early middle age.  In some cases this
might be contributed to, or caused by, workplace conditions.  Although
the Control of Substances Hazardous to Health Regulations were brought
into effect in 1989 to help protect workers from all manner of
illness-causing substances, a National Asthma Campaign study in 1985
revealed that 80% of small to medium-sized businesses had not carried
out their duties under COSHH to take the necessary steps to protect
their employees from sensitisers to asthma.  Department of Health
figures indicate over £350 million a year spent by NHS in the treatment
of occupational asthma, that is to say in the treatment of what, could
be a preventable condition.  It is draining a huge amount
out of public health care funds.

The reason for this letter is to seek your support with the occupational
asthma campaign.  Alison Crawley,of the Law Society's professional
ethics division, was recently quoted in The Lawyer magazine,
referring specifically to ALeRT and its asthma campaign as saying"it
could be said lawyers doing this type of work are improving safety
standards in places of work".

In essence, we would like you to invite those of your patients who are
suffering from asthma, that may have been caused or exacerbated by their
working conditions, to seek advice from ALeRT, so that they have the
opportunity, should they wish, to submit a claim for compensation.  All
of your patients who wish to have advice will be referred through this
office to a member firm local to your area, who will then make contact
with your patient.


A protocol has been designed, whereby in each case, a report on the
current state of knowledge of the latest scientific and medical
literature on the risks of the particular sensitisers used in the
patient's workplace, together with a report indicating what protective
measures under COSHH, ought to have been and which of these were not,
implemented, thus indicating the level of exposure to the sensitiser,
will be provided by scientists and chemists, as members of ALeRT's
expert team.  If these reports are in support of a claim, i.e. the
patient has been exposed to a specific recognised sensitiser in
circumstances which suggest such exposure was in excess of permitted
levels, they will then be sent to the GP who has referred the client,
with an instruction to provide a medico-legal report.

A format for that report has been agreed by me with ALeRT, which I can
provide to you if you are agreeable to assisting with the campaign.  The
intention is that this report will suffice for the initial stages of a
case, but that the doctors giving the report will not be required to
give evidence in court (that will be done by consultant physicians in
those cases that go to trial).

A fixed fee has been agreed with ALeRT of £150 per report.  Further , to
allay the unfortunately all too familiar fears, ALeRT have assured me
that all reports will be paid for within thirty days of receipt.  I will
act as liaison between the referring/reporting doctors and will be
available at all times to ensure the system functions well.

As to the detail, all that we would request is that you would ask your
practice nurse to pass on to patients a copy of the attached leaflet.
Your practice nurse may also complete the attached short questionnaire
form and return it to this office.  The completion of the questionnaire
is not strictly necessary, and ALeRT is happy to do that themselves over
the telephone, with your patient if you prefer.

Leaflets could also be left in the waiting area for patients to pick up
and read, and the attached poster could be displayed.

I do hope you are agreeable to assisting with this initiative.  Not only
will your patients appreciate your concern for their rights in law, you
may, in being given the scientific reports, be adding to your own
knowledge of the agents that are causing asthma in the workplace.

You are free to copy the enclosures, or else we can send you a supply.

Yours sincerely,





Dr Vinod Saksena, MB,BS,DCH