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Title: Development and validation of a diagnostic tool for occupational asthma based on serial lung function measurements
Author: Moore, Vicky Clare
ISNI:       0000 0004 2692 7031
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2010
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Serial peak expiratory flow measurements (PEF) are recommended as an initial investigation in the confirmation of occupational asthma. Plotting measurements in Oasys gives reproducible results and can be used by non-experts. I report a new analysis, the area between curves (ABC) score, which gives 72% sensitivity and 100% specificity using a cut off of 15 L/min/h. Two-hourly measurements of PEF require 8 work days and 3 rest days for sensitive and specific analysis. Serial PEF records with long periods off work (≥ 4 consecutive days) show improved sensitivity from 73% to 80%, implying that 7 more workers in every 100 would be diagnosed. In a comparison of forced expiratory volume in one second (FEV1) to PEF, PEF was more sensitive to diurnal changes than FEV1, although FEV1 was more reproducible. Exhaled breath nitric oxide (FENO) showed similar ABC scores between those with normal and raised FENO. FENO was significantly correlated to methacholine reactivity. In shift workers, mean ABC scores were increased on morning shifts compared to nights, but the cut off of 15 L/min/h would be applicable across all shift types. The ABC score is a new robust method of confirming occupational asthma requiring shorter records than the Oasys score.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RA0421 Public health. Hygiene. Preventive Medicine