The Validation of Work-related Self-reported Asthma Exacerbation

Aimee R Bolen ^1*, Paul K Henneberger ², Xiaoming Liang ¹, Susan R Sama ³, Peggy A Preusse ⁴, Richard A Rosiello ⁴ and Donald K Milton ³

¹ National Institute for Occupational Safety and Health, United States
² National Institute for Occupational Safety and Health, United Kingdom
³ Harvard School of Public Health; Department of Work Environment, UMASS, United States
⁴ Fallon Clinic Research Department, United States

^* To whom correspondence should be addressed. E-mail: abolen{at}health-ra.com.

Accepted 28 October 2006

Abstract

Objectives: The objective of this study was to determine the validity of work-related self-reported exacerbation of asthma using the findings from serial peak expiratory flow (PEF) measurements as the standard.

Methods: Adults with asthma treated in a health maintenance organization were asked to conduct serial spirometry testing at home and at work for 3 weeks. Self-reported respiratory symptoms and medication use were recorded in two ways: a daily log completed concurrently with the serial PEF testing and a telephone questionnaire administered after the PEF testing. Three researchers evaluated the serial PEF records and judged whether a work relationship was evident.

Results: Ninety-five (25%) of 382 working adults with asthma provided adequate serial PEF data, and 13 (14% of 95) were judged to have workplace exacerbation of asthma based on these data. Self-reported concurrent medication use was the most valid single operational definition, with a sensitivity of 62% and a specificity of 65%.

Conclusions: Self-reports of symptoms and medication use failed to identify many people who had evidence of workplace exacerbation of asthma based on serial PEF measurements.

Keywords: asthma, serial spirometry, workplace studies

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