Interpreting screening questionnaires: specific respiratory symptoms and their relationship to objective test results

Assessment of the Respiratory Health of Working US Coal Miners Since 2014-Radiography, Spirometry, and Symptom Assessments

OBJECTIVE

The aim of the study is to summarize Coal Workers' Health Surveillance Program findings since 2014, focusing on prevalence of radiographic pneumoconiosis and abnormal spirometry by region.

METHODS

Analysis included the most recent Coal Workers' Health Surveillance Program encounter for working miners during October 1, 2014-June 30, 2022. Central Appalachia consists of Kentucky, Virginia, and West Virginia.

RESULTS

Pneumoconiosis prevalence was highest among underground miners, with 318 (6.2%) having radiographic evidence of disease. Central Appalachian miners were more likely to have evidence of pneumoconiosis (relative risk = 4.1 [3.4-5.0]) and abnormal spirometry (relative risk = 1.4 [1.2-1.6]) compared with all others.

CONCLUSIONS

Central Appalachia is a hotspot for pneumoconiosis, as well as for other indicators of respiratory impairment in coal miners. Outreach for occupational respiratory health surveillance should focus on those areas most heavily affected, ensuring that miners are not hindered by perceived or actual barriers to this secondary intervention.

Cross-sectional survey of workers exposed to aliphatic diisocyanates using detailed respiratory medical history and questions regarding accidental skin and respiratory exposures

OBJECTIVES

To identify possible cases of occupational asthma and assess accidental skin and inhalation exposures to aliphatic diisocyanates.

METHODS

Seventy-three employees from two plants, manufacturing or producing aliphatic diisocyanates, were surveyed using a detailed respiratory history questionnaire with additional questions on accidental skin and inhalation exposures. Further reviews of medical records and interviews were used to determine whether any of 15 employees with questionable responses had developed occupational asthma.

RESULTS

No cases of occupational asthma were identified. Nevertheless, many employees reported occasional accidental unprotected skin exposures and/or detecting the odor of 1,6-hexamethylene diisocyanate or isophorone diisocyanate.

CONCLUSIONS

Consistent with a previous study, no cases of occupational asthma were identified from exposure to 1,6-hexamethylene diisocyanate, isophorone diisocyanate, methylene bis(4-cyclohexyl isocyanate), or their polyisocyanates even though many employees reported detection of odors (93%) or skin exposures (53%).

Screening for occupational asthma by using a self-administered questionnaire in a clinical setting

OBJECTIVE

Because of its high prevalence, early screening for occupational asthma (OA) is crucial. We aimed to evaluate the screening performance of the Occupational Asthma Screening Questionnaire-11 items (OASQ-11) in a clinical setting.

METHODS

Between January 2009 and December 2011, 169 workers referred for potential OA to our hospital completed the OASQ-11 and underwent workups to determine the final diagnosis. The discriminative abilities of the OASQ-11 as a whole and in relation to demographic and exposure parameters were determined by the area under the receiving operator characteristic curve (AUC).

RESULTS

Model 1, consisting of the OASQ's items, showed fair discrimination (AUC, 0.69; 95% confidence interval, 0.58 to 0.80). Addition of age and exposure duration to model 1 improved discrimination (AUC, 0.80; confidence interval, 0.72 to 0.88).

CONCLUSION

A simple model consisting of the OASQ-11's items, age, and exposure duration could well discriminate subjects with OA in a clinical setting.