Epidemiology and surveillance

Lung health in workers exposed to reed dust

We conducted a cross-sectional survey in a cellulose plant among 109 reed workers, exposed to reed dust and 78 unexposed office workers, to investigate respiratory health effects of reed dust exposure. Investigations included dust measurements, serum total IgE, skin prick test, pulmonary function testing and questionnaire on respiratory symptoms. Total dust level in the reed processing unit was higher than the office (9.7 and 0.02 mg/m3, respectively). Reed workers had a higher rate of current smoking (67% and 46%, respectively). After the adjustment for smoking status and age, reed dust exposure was significantly associated with wheezing, chronic cough, dyspnea, itching eyes and itching nose. Chest tightness and ODTS symptoms were only reported by reed workers (27.5% and 23.9%, respectively). After the adjustment for pack-years of smoking, percentage of predicted FEV1, FVC, FEV1/FVC and FEF25-75 in reed workers were significantly lower than office workers. Among reed workers, wheezing was associated with older age (>40 years) and ever smoking, and cross-shift decline in FVC and FEV1 with shorter duration of work. Reed dust exposure in the workplace could provoke respiratory symptoms, possibly due to an irritating effect. Health selection bias is likely, and could have underestimated the health effects of reed dust exposure.

Health services utilization reporting in respiratory patients. Pharmacy Medication Monitoring Program Advisory Board

Health services utilization information is important for outcomes research. This study assessed the reliability of self-reports of health services utilization in respiratory patients. Patients reported health services use and other information during three telephone interviews over 6 months. Reports of visits to general practitioners (GPs), specialists, emergency room (ER)/clinics, and hospital admissions were compared with corresponding fee service claims in the Ontario Health Insurance Plan administrative database in 83 subjects. Agreement between the two sources was calculated using observed agreement and estimated kappa. Substantial agreement was found for hospital admissions and visits to respiratory specialists. Agreement was moderate for GP visits and slight for ER/clinic visits. Patient self-report of ER use appeared unreliable and may be related to imprecise questionnaire wording and inadequately defined fee service codes. The findings emphasize the importance of the methods used to assess the reliability of patient self-reports used in outcomes research.