Updated Software for Use with a Peak Flow Meter to Evaluate Patients Whose Asthma Symptoms Are Worse at Work

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  Peak flow monitoring remains the most cost effective way to evaluate a patient who gives a history that their asthma is worse at work. This newsletter describes updated software that makes it easier to review the multiple readings recorded by the patient and interpret whether the results are consistent with work-related asthma. Unlike the typical recommendation of using a peak flow meter two to three times a day to assist in management of an asthma patient, peak flow monitoring performed as part of the diagnostic workup of work-related asthma is recommended every two hours while the patient is awake to maximize the sensitivity of the testing (1). Although, one study found that peak flow testing done at least four times a day had equivalent sensitivity to testing every two hours. Testing is recommended over a four week period, two weeks at work and two consecutive weeks off work to maximize sensitivity. Patients will typically need a note from their provider that the patient will be off work for two weeks for medical testing. For many patients this will not be possible, but at least one week away from work is recommended. If the patient changes their work shift or the dose or type of asthma medication they are taking, or they develop a respiratory infection during the three to four week testing period, interpretation of the peak flow results becomes more complicated and it may be necessary to repeat the peak flow testing. Clearly, peak flow meters have limitations. Peak flow testing is effort dependent, requires a cooperative patient and the results can be falsified. Table 1 summarizes changes that may suggest the patient has falsified their peak flow results. Portable flow-sensing spirometers that electronically record the results as well as have flow diagrams to evaluate effort address the limitations of peak flow meters but these devices are not as readily available, are more expensive, require the device to be returned and require additional training of the patient. The sensitivity of peak flow testing in comparison to specific inhalation challenge testing is 64% (95% CI 43-80%) and the specificity is 77% (95% CI 67-85%). Higher sensitivity and specificity for peak flow has been reported in comparison to expert opinion, 75% and 94%. [Description provided by NIOSH]
• Subjects:
  Asthma, Occupational Diagnosis Epidemiology Occupational Exposure Occupational Health Safety Software
• Keywords:
  Computer Software Diagnostic Techniques Occupational Asthma Occupational Exposure Surveillance
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  23
• Issue:
  3
• NIOSHTIC Number:
  nn:20054559
• Citation:
  Project S.E.N.S.O.R. News 2012 May; 23(3):1-4
• Contact Point Address:
  MSU-CHM, 117 West Fee Hall, East Lansing, MI 48824-1316
• Federal Fiscal Year:
  2012
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5cbacd45a1a077eeb4895a8a8013ff277fc405392c937285e2bec0a65ab23a881cc74981bdae2a5ee6b7f931be279cb5e9b88d372d5b04b6bfd8f648da0f20f9
• Download URL:
  https://stacks.cdc.gov/view/cdc/217084/cdc_217084_DS1.pdf
• File Type:
  [PDF - 234.17 KB ]