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Occupational asthma

The development and test re-test reliability of a work-related asthma screening questionnaire

, MSc, , MSc, , MSc, , MSc, , MSc, , MHSc, MD, , MHSc, CIH, , MD, MSc, , PhD, , MD, MS, , MBBS & , MD, MSc show all
Pages 279-288 | Received 28 Mar 2014, Accepted 16 Aug 2014, Published online: 09 Sep 2014
 

Abstract

Objective: Work-related asthma (WRA) is under-recognized and delays in recognition contribute to long-term morbidity. The objective of the project was to develop a WRA screening questionnaire for use by primary care providers in the assessment of individuals with asthma, and to evaluate the respondent burden, test re-test reliability and face validity of the questionnaire. Methods: A literature search was undertaken and an expert advisory committee was convened. A questionnaire was drafted and assessed for feasibility of use and content validity. The study enrolled patients with asthma attending outpatient clinics and an asthma education center. Participants were asked to respond to the questionnaire on two occasions, and comment on the content (face validity) and ease of completion (respondent burden). Ethics approval was obtained from an institutional review board. Results: A 14-item self-administered screening questionnaire was created. Thirty-nine participants were recruited, and 26 participants completed a second administration of the questionnaire. The items on the relation of asthma symptoms to work demonstrated substantial agreement between testings. The workplace exposures items were found to have good reproducibility. The majority of participants denied that items were repetitive, not useful or difficult to understand. Conclusions: We have developed a WRA screening questionnaire designed to aid primary care providers in the recognition of possible WRA. The tool exhibited content and face validity, good test re-test reliability and low respondent burden. Participant feedback is being considered in revisions of the questionnaire.

Acknowledgements

We would like to acknowledge Dr. Patti Groome for contribution to these statistical methods. We would also like to acknowledge Dr. Peter Bell for his feedback in the development of the WRASQ(L) as well as research assistant Kendra Barrick, for her assistance in the assembly of instruments in the literature search.

Declaration of interest

The authors alone are responsible for the content and writing of the article. The test re-test reliability analysis in this article is based on statistical methodology developed by K.R.K. as part of an academic thesis in the Department of Public Health Sciences at Queen’s University, Kingston, Ontario (supervisors: M.D.L., Dr. Patti Groome).

K.R.K., S.M.D., S.E.T., J.P.M., C.L., and T.T. report no conflicts of interest. J.O.C. has received an honorarium from Takeda Canada for conducting a workshop on inhalation devices for asthma medication to primary care practitioners. D.L.H. has received peer-reviewed research funding from the Ontario Ministry of Labor, the Ontario Workplace Safety and Insurance Board (WSIB), and the Social Sciences and Humanities Research Council. I.K. has received peer-reviewed research funding from the Ontario Ministry of Labor and the Ontario WSIB. G.L. has received research funding as an investigator from the Ontario WSIB Research Advisory Council, which supported research assistants and data analyses, but no funding went to the investigators. S.M.T. has received previous funding for research studies on WRA from the Ontario WSIB, the Worker’s Compensation Board (WCB) of Manitoba, and WorkSafe BC, and has performed clinical consultations of patients at the request of the Ontario WSIB. M.D.L. has received research funding from the Government of Ontario, the Ontario Lung Association, MPEX Pharmaceuticals, Pharmaxis Ltd., AllerGen NCE Inc. (the Allergy, Genes and Environment Network), the Ontario Thoracic Society, the Canadian Cystic Fibrosis Foundation, Queen’s University, Glaxo Smith Kline Inc., Janssen Inc., and speaker honoraria from the Ontario Lung Association. G.L., C.L., T.T. and S.M.T. were co-investigators with MDL on the WRA and Allergy Prevention and Early Detection (WRAAPED) Research Program team grant, supported by AllerGen NCE Inc. The work completed for this specific project was funded by both AllerGen NCE Inc. (grant number #07C4) and the Ontario WSIB.

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