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Walters, Gareth
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Gareth is a respiratory physician with a specialist interest in work-related airways and interstitial lung diseases. He is clinical lead for the supra-regional NHS Occupational Lung Disease Service at Birmingham Chest Clinic, UK, and an Honorary Senior Clinical Research Fellow at the Institute of Applied Health Research, University of Birmingham where he supervises and carries out research into the causes and impact of these diseases. He is a member of both the Group of Occupational Respiratory Disease Specialists (GORDS) UK and the Industrial Injuries Advisory Council.
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Publication Metadata only Enhancing the health of NHS staff: eTHOS - protocol for a randomised controlled pilot trial of an employee health screening clinic for NHS staff to reduce absenteeism and presenteeism, compared with usual care.(BMC, 2022-07-27) Adams, Rachel; Jordan, Rachel; Adab, Peymané; Barrett, Tim; Bevan, Sheriden; Cooper, Lucy; DuRand, Ingrid; Hardy, Pollyanna; Heneghan, Nicola; Jolly, Kate; Jowett, Sue; Marshall, Tom; O'Hara, Margaret; Rai, Kiran; Rickards, Hugh; Riley, Ruth; Sadhra, Steven; Tearne, Sarah; Walters, Gareth; Sapey, Elizabeth; Walters, Gareth; Walters, Gareth; Respiratory Medicine; Medicine; Medical and Dental; Walters, Gareth; Sapey, ElizabethBackground: Staff absenteeism and presenteeism incur high costs to the NHS and are associated with adverse health outcomes. The main causes are musculoskeletal complaints and mental ill-health, which are potentially modifiable, and cardiovascular risk factors are also common. We will test the feasibility of an RCT to evaluate the clinical and cost-effectiveness of an employee health screening clinic on reducing sickness absenteeism and presenteeism. Methods: This is an individually randomised controlled pilot trial aiming to recruit 480 participants. All previously unscreened employees from four hospitals within three UK NHS hospital Trusts will be eligible. Those randomised to the intervention arm will be invited to attend an employee health screening clinic consisting of a screening assessment for musculoskeletal (STarT MSK and STarT Back), mental (PHQ-9 and GAD-7) and cardiovascular (NHS Health Check if aged ≥ 40, lifestyle check if < 40 years) health. Screen positives will be given advice and/or referral to recommended services. Those randomised to the control arm will receive usual care. Participants will complete a questionnaire at baseline and 26 weeks; anonymised absenteeism and staff demographics will also be collected from personnel records. The co-primary outcomes are as follows: recruitment, referrals and uptake of recommended services in the intervention arm. Secondary outcomes include the following: results of screening assessments, uptake of individual referrals, reported changes in health behaviours, acceptability and feasibility of intervention, indication of contamination and costs. Outcomes related to the definitive trial include self-reported and employee records of absenteeism with reasons. Process evaluation to inform a future trial includes interviews with participants, intervention delivery staff and service providers receiving referrals. Analyses will include presentation of descriptive statistics, framework analysis for qualitative data and costs and consequences presented for health economics. Discussion: The study will provide data to inform the design of a definitive RCT which aims to find an effective and cost-effective method of reducing absenteeism and presenteeism amongst NHS staff. The feasibility study will test trial procedures, and process outcomes, including the success of strategies for including underserved groups, and provide information and data to help inform the design and sample size for a definitive trial. Trial registration: ISRCTN reference number 10237475 .Publication Metadata only Disparities in food allergy amongst British South Asian adult patients in central England(Elsevier, 2025-09-05) Osborne, Toni; Walters, Gareth; Baretto, Richard; Krishna, Mamidipudi Thirumala; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Dietitics; Occupational Respiratory Medicine; Pathology; Allied Health Professional; Medical and Dental; Osborne, Toni; Walters, Gareth; Baretto, Richard; Krishna, Thirumala; Krishna, ThomasBackground: Published evidence suggests an increased burden of food allergy (FA) amongst ethnic minority groups resident the United States of America and Australia, with limited data from the United Kingdom. The West Midlands Regional Allergy Service serves British Caucasian White and Ethnic Minority Groups with a large proportion being British South Asian, making it important to explore ethnicity-based differences in clinical outcomes for FA. Aims: To compare clinical outcomes of FA and other atopic diseases between Caucasian White and South Asian patients attending the regional allergy service in West Midlands. Methods: This prospective cross-sectional, observational study (N = 29 White and N = 21 South Asian) used a structured questionnaire with dichotomous, multiple-choice, and scaled questions to gather data on age, ethnicity, FA (including allergens, allergic reactions, adrenaline auto-injector use, and emergency department visits), and other atopic conditions. Main results: 1.) South Asians had significantly (p = 0.006) more frequent FA reactions. 2.) Poorly controlled eczema and asthma were significantly (eczema p = 0.015, asthma p = 0.022) more common amongst South Asians. 3.) The burden of asthma, eczema, and allergic rhinitis was similar between groups. 4.) Significantly more White patients (p = 0.027) with asthma were on higher treatment steps. Conclusion: British South Asian patients with FA attending the West Midlands regional allergy service had more frequent allergic reactions and poorly controlled asthma and eczema compared to British Caucasian White patients. This highlights the need for improved education and compliance. Larger multi-centre studies are needed to gain further insight into ethnicity-based disparities in FA.Publication Metadata only Difficult-to-treat asthma patients from ethnic minority groups in central England are at an enhanced risk of house dust mite sensitisation(BMC, 2023-10) Mansur, Adel H; Marsh, Julie; Bahron, Ali; Thomas, Maximillian; Walters, Gareth; Busby, John; Heaney, Liam G; Krishna, Mamidipudi Thirumala; Walters, Gareth; Walters, Gareth; General Medicine; IT Services; Pathology; Additional Professional Scientific and Technical Field; Admin and Clerical; Estates and Ancillary; Medical and Dental; Mansur, Adel; Marsh, Julie; Bahron, Ali; Thomas, Maximillian; Walters, Gareth; Krishna, Mamidipudi ThirumalaA total of 1272 patients [White 1016 (79.9%), EMG 256 (20.1%) EMG] with a median age of 51 years (range 16-97) were included in the analysis. Patients from EMG were more likely (64%) to reside in the worst scale of index of multiple deprivation (IMD) than the White patients (25.5%), p < 0.0001. Positive HDM sensitisation was more prevalent in the EMG than in the White group [142/216 (66%) versus 375/842 (45%), p < 0.0001]. The median HDM ssIgE level was higher in the EMG than in the White group [3.0 KUA/L (IQR 0.06, 11.5) versus 0.1 (0.01, 3.0), p < 0.000001]. The odds ratio for positive sensitisation to HDM conveyed by the EMG status was 2.61 (95%CI, 1.8-3.8), p < 0.0001. Compared to the White group, the EMG had higher median total serum IgE [326 KU/L (115, 971) versus 114 (29.8, 434.8), p < 0.000001], higher blood eosinophil count (0.36 × 109 (0.18, 0.62) versus 0.23 (0.1,0.47), p < 0.000001), were marginally more atopic (79.2% vs. 75.6%, p = 0.098) and were less likely to being on maintenance oral corticosteroids (22% vs. 39.7%, p < 0.0001).Publication Metadata only Health screening clinic to reduce absenteeism and presenteeism among NHS Staff: eTHOS a pilot RCT.(NIHR Journals Library, 2024-08-12) Adams, Rachel; Jordan, Rachel E; Maher, Alisha; Adab, Peymane; Barrett, Timothy; Bevan, Sheriden; Cooper, Lucy; DuRand, Ingrid; Edwards, Florence; Hardy, Pollyanna; Harris, Ciara; Heneghan, Nicola R; Jolly, Kate; Jowett, Sue; Marshall, Tom; O'Hara, Margaret; Poyner, Christopher; Rai, Kiran; Rickards, Hugh; Riley, Ruth; Ives, Natalie; Sadhra, Steven; Tearne, Sarah; Walters, Gareth; Sapey, Elizabeth; Walters, Gareth; Walters, Gareth; Medicine - Reader and Honorary Consultant in Respiratory Medicine.; Additional Professional Scientific and Technical Field; Sapey, ElizabethThis award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/42/42) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 23. See the NIHR Funding and Awards website for further award information.Publication Metadata only Could a behaviour change intervention be used to address under-recognition of work-related asthma in primary care? A systematic review(Royal College of General Practitioners, 2024-11-21) Walters, Gareth Iestyn; Foley, Harriet; Huntley, Christopher Charles; Naveed, Anadil; Nettleton, Kimberley; Reilly, Christopher; Thomas, Maximillian; Walker, Claire; Wheeler, Kyrie; Walters, Gareth; Walters, Gareth; Occupational Respiratory Medicine; Medical and Dental; Walters, Gareth; Huntley, Christopher; Thomas, Maximillian; Walker, Claire; Wheeler, KyrieWe included 14 studies from n=768 retrieved citations, comprising 3 randomised control trials, 1 uncontrolled experimental study, and 10 studies employing recognized multi-step BC methodologies. None of the studies were concerned with identification of asthma. BCIs had been developed for facilitating screening programmes (5), implementing guidelines (3) and individual case finding (6). Five studies measured effectiveness, in terms of screening adherence rates, pre-/post-intervention competency, satisfaction and usability, for clinicians, though none measured diagnostic rates.