Peak flow rate records in the diagnosis of occupational asthma due to colophony.

Abstract

Peak expiratory flow rate (PEFR) has been measured hourly from waking to sleeping in 29 workers with respiratory symptoms exposed to the fumes of soft soldering fluxes containing colophony (pine resin). Thirty-nine records of mean length 33 days have been analysed, and the results compared with the occupational history and bronchial provocation testing in the same workers. From (Schilling, 1956). Symptoms most severe on the first day of the working week are seen in a wide range of diseases where fever is prominent, and wheeze is often present. These include metal fume fever (Greenhow, 1862), humidifier fever (Pickering et al, 1976), meat wrapper's asthma (Sokol, 1973), feather picker's asthma (Plessner, 1960), and grain fever (Williams et al, 1964;Kleinfeld et al, 1968).Measurement of lung function before and after a working shift has formed the basis of objective tests for occupational asthma in the work situation. This has often been disappointing. Schoenberg and Mitchell (1975) (1979b) were able to show a fall in FEV1 of 10% or more over at least one of three work shifts in a third of a group of workers in an electronics factory, all of whom had symptoms highly suggestive of occupational asthma. Most workers with colophony sensitivity have immediate asthmatic reactions on bronchial provocation testing (Burge et al, 1978), which may explain these better 308 on 11 May 2018 by guest. Protected by copyright.

Development of OASYS-2: a system for the analysis of serial measurement of peak expiratory flow in workers with suspected occupational asthma.

“…Development set 1 was the largest with all types of PEF record being represented including the most difficult type -namely, those which were equivocal for the presence of a work-related effect (14%) -and 50% were not thought to show a workrelated effect. A similar distribution of PEF records was seen in development set 2 Expert assessed group (overall weighted score) Figure 4 Comparison of visual weighted whole record scores with OASYS-2 scores for the development set 2. Cut off point Figure 5 Curve used to determine the cut offpoint for whc maximises sensitivity ( Factors which reduce the sensitivity and five records came from specificity of analysis by OASYS-2 include the upational asthma, and fact that it still relies on self-recorded PEF ded 2-51 in two, both of which suffers from problems of poor technique office workers who gave and sometimes, when compensation is an issue, y symptoms on the ques-frank falsification.…”

Effect of peak expiratory flow data quantity on diagnostic sensitivity and specificity in occupational asthma

“…This is both sensitive and specific [2][3][4][5][6]. It was originally suggested that PEF measurement should be performed every 2 h whilst awake for a minimum of 4 weeks, including periods at and away from work [3].…”

Serial PEF measurement is superior to cross-shift change in diagnosing occupational asthma

“…This can happen in individuals displaying only an immediate reaction to exposure; however, many other patterns of response are seen. Late reactions occur frequently in occupational asthma and may not become evident for many hours after exposure has commenced; symptoms may not occur until the end of a shift, do not fully recover overnight, and may progressively worsen through the working week [12,13]. In a study on occupational asthma in an electronics factory, eight out of 58 workers with wheeze or breathlessness that improved at the weekend described their symptoms as commencing o7 h after the beginning of their shift.…”