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The validation of work-related self-reported asthma exacerbation
  1. Aimee R Bolen1,
  2. Paul K Henneberger1,
  3. Xiaoming Liang1,
  4. Susan R Sama2,
  5. Peggy A Preusse3,
  6. Richard A Rosiello3,
  7. Donald K Milton2
  1. 1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
  2. 2Harvard School of Public Health, Boston, Massachusetts, USA
  3. 3Fallon Clinic Research Department, Worcester, Massachusetts, USA
  1. Correspondence to:
 P K Henneberger
 National Institute for Occupational Safety and Health/CDC, M/S H2800, 1095 Willowdale Road, Morgantown, WV 26501, USA; pkh0{at}


Objective: 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 organisation 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: 95 of 382 (25%) working adults with asthma provided adequate serial PEF data, and 13 of 95 (14%) were judged to have workplace exacerbation of asthma (WEA) 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: A work-related pattern of self-reported asthma symptoms or medication use was usually not corroborated by serial PEF testing and failed to identify many people who had evidence of WEA based on the serial PEF measurements.

  • HMO, Health Maintenance organization
  • NIOSH, National Institute for Occupational Safety and Health
  • OASYS-2, Occupational Asthma System 2
  • PEF, peak expiratory flow
  • SENSOR, Sentinel Event Notification System for Occupational Risks
  • WEA, workplace exacerbation of asthma
  • WRA, work-related asthma

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  • Published Online First 19 December 2006

  • Funding: The funding source was the Centers for Disease Control and Prevention.

  • Competing interests: None.

  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health (NIOSH). Mention of any company or product does not constitute endorsement by NIOSH.