Occupational Asthma Reference

Anees W, Huggins V, Blainey D, Pantin CFA, Robertson K, Burge PS, Evaluation of an expert system for the interpretation of serial peak expiratory flow measurements in the diagnosis of occupational asthma in a field trial, HSE Books, 2002;450:1-14,

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Known Authors

David Blainey, Essex, UK David Blainey

Sherwood Burge, Oasys Sherwood Burge

Charles Pantin, Keele, UK Charles Pantin

Wasif Anees, Oasys Wasif Anees

Vicky Moore, Oasys Vicky Moore

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Abstract

Oasys-2 is a computer based analytical tool for the evaluation of serial measurements of peak expiratory flow (PEF). This study aimed to evaluate Oasys-2 in an epidemiological setting.

The study reviewed extant PEF records from 104 grain workers, and prospectively studied 228 further workers. Prospective PEF records were kept by 61%, 88% from both parts contained =4 readings/day. As the two independent experts lacked agreement on the minimal data quantity required to diagnose occupational asthma, a data reduction exercise was completed in non-grain workers with independently validated diagnoses to establish the relationship between data quantity and diagnostic sensitivity and specificity. Specificity >87% and sensitivity >70% was achieved with =3 complexes, =4 readings per day and =3 consecutive days at work. 67% of PEFs met these criteria, many failures lacked 3 consecutive grain exposed days.

There was a poor correlation between PEF records, RAST's and questionnaire responses. 33 PEF records showed a work related effect, 39 had questionnaire responses suggesting occupational asthma, but only 7 were common to both groups. The PEF records identified a different group of affected workers from questionnaires and RAST's, the group with work-related PEF measurements showed more obstructive spirometry than those identified by the other methods.

Oasys-2 is a computer based analytical tool for the evaluation of serial measurements of peak expiratory flow (PEF). This study aimed to evaluate Oasys-2 in an epidemiological setting.

The study reviewed extant PEF records from 104 grain workers, and prospectively studied 228 further workers. Prospective PEF records were kept by 61%, 88% from both parts contained ?4 readings/day. As the two independent experts lacked agreement on the minimal data quantity required to diagnose occupational asthma, a data reduction exercise was completed in non-grain workers with independently validated diagnoses to establish the relationship between data quantity and diagnostic sensitivity and specificity. Specificity >87% and sensitivity >70% was achieved with =3 complexes, =4 readings per day and =3 consecutive days at work. 67% of PEFs met these criteria, many failures lacked 3 consecutive grain exposed days.

There was a poor correlation between PEF records, RAST's and questionnaire responses. 33 PEF records showed a work related effect, 39 had questionnaire responses suggesting occupational asthma, but only 7 were common to both groups. The PEF records identified a different group of affected workers from questionnaires and RAST's, the group with work-related PEF measurements showed more obstructive spirometry than those identified by the other methods.

Plain text: Oasys-2 is a computer based analytical tool for the evaluation of serial measurements of peak expiratory flow (PEF). This study aimed to evaluate Oasys-2 in an epidemiological setting. The study reviewed extant PEF records from 104 grain workers, and prospectively studied 228 further workers. Prospective PEF records were kept by 61%, 88% from both parts contained >=4 readings/day. As the two independent experts lacked agreement on the minimal data quantity required to diagnose occupational asthma, a data reduction exercise was completed in non-grain workers with independently validated diagnoses to establish the relationship between data quantity and diagnostic sensitivity and specificity. Specificity >87% and sensitivity >70% was achieved with >=3 complexes, >=4 readings per day and >=3 consecutive days at work. 67% of PEFs met these criteria, many failures lacked 3 consecutive grain exposed days. There was a poor correlation between PEF records, RAST's and questionnaire responses. 33 PEF records showed a work related effect, 39 had questionnaire responses suggesting occupational asthma, but only 7 were common to both groups. The PEF records identified a different group of affected workers from questionnaires and RAST's, the group with work-related PEF measurements showed more obstructive spirometry than those identified by the other methods. Oasys-2 is a computer based analytical tool for the evaluation of serial measurements of peak expiratory flow (PEF). This study aimed to evaluate Oasys-2 in an epidemiological setting. The study reviewed extant PEF records from 104 grain workers, and prospectively studied 228 further workers. Prospective PEF records were kept by 61%, 88% from both parts contained ?4 readings/day. As the two independent experts lacked agreement on the minimal data quantity required to diagnose occupational asthma, a data reduction exercise was completed in non-grain workers with independently validated diagnoses to establish the relationship between data quantity and diagnostic sensitivity and specificity. Specificity >87% and sensitivity >70% was achieved with >=3 complexes, >=4 readings per day and >=3 consecutive days at work. 67% of PEFs met these criteria, many failures lacked 3 consecutive grain exposed days. There was a poor correlation between PEF records, RAST's and questionnaire responses. 33 PEF records showed a work related effect, 39 had questionnaire responses suggesting occupational asthma, but only 7 were common to both groups. The PEF records identified a different group of affected workers from questionnaires and RAST's, the group with work-related PEF measurements showed more obstructive spirometry than those identified by the other methods.

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