Occupational Asthma Reference

Moscato G, Dellabianca A, Paggiaro P, Bertoletti R, Corsico A, Perfetti L, Peak expiratory flow monitoring and airway response to specific bronchial provocation tests in asthmatics, Monaldi Arch Chest Dis, 1993;48:23-28,

Keywords: oa, peak flow, FEV1, ch, methods

Known Authors

Pierluigi Paggiaro, Ospedale Cisanello, Pisa, Italy Pierluigi Paggiaro

Giana Moscato, Fondazione Salvatore Maugeri, Pavia Giana Moscato

Luca Perfetti, Fondazione Salvatore Maugeri, Pavia Luca Perfetti

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Abstract

To assess the validity of peak expiratory flow (PEF), measured by means of a peak flow meter, in comparison to forced expiratory volume in one second (FEV1) for measuring the airway response during specific bronchial challenges, we registered PEF and FEV1 in a random sequence during 75 positive (decrease in FEV1 of : or = 15% from baseline) and 75 negative (decrease in FEV1 : 15% from baseline) challenges with chemicals or allergens. The correlation between PEF and FEV1 in terms of absolute values and of percentage of change from baseline was statistically highly significant (p : 0.001) in all challenges and in the different pattern of response, immediate, dual and late. Relative operating characteristic analysis showed that an absolute decrease in PEF of : or = 70 l.min-1 in the immediate and of : or = 80 l.min-1 in the late phase of the response (cut-off points) gave optimal discrimination between challenges with a bronchoconstrictive response (defined as a FEV1 decrease : or = 15% from baseline), and challenges without. These cut-off points, however, were highly specific (92 and 93.3%, respectively), but not as sensitive (70.6 and 61.1%, respectively), and smaller absolute changes in PEF from baseline do not exclude a bronchoconstrictive response. Our data suggest that PEF readings are a useful diagnostic tool in assessing the airway response during a specific bronchial challenge in asthmatics, although with some limitations. PEF readings can be used to monitor the late response to a challenge during the evening and the night if PEF readings are carefully considered in relation to clinical symptoms

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