Hayati Fazel, Maghsoodloo Seed, DeVivo Michael J, Thomas Robert E, Lemiere Catherine
Edgewood College, Madison, WI 53711, USA.
Am J Ind Med. 2008 Mar;51(3):223-8. doi: 10.1002/ajim.20559.
Asthma is the most common occupational respiratory disorder in the industrialized world. In this research we investigated the effectiveness of quality control chart as a method to explore the work-relatedness of asthma using peak expiratory flow (PEF) as the variable of interest.
PEF measurements were recorded from several workers suspected of having occupational asthma. The measurements were recorded for a period of 2 weeks at work and two away from work. For each subject, average [symbol: see text] quality control chart was developed and analyzed using Shewhart methods.
Using the ratio of average daily PEF diurnal variation at work to the baseline average diurnal variation, quality control chart detected and characterized increased variation in PEF between the periods at workplace and away from workplace. This ratio was evaluated at 15% and 20% and compared to the results of the gold standard. A ratio of greater than 15% produced a sensitivity of 94% and specificity of 61%. These results are as good as and in some cases better than the previously published work.
Quality control chart is an effective and inexpensive method for early intervention to detect workers suspected for occupational asthma. Also, the findings in this article are an invitation for further research in occupational asthma using quality control chart methods for other indices of airways obstruction (FEV-1, RAW) or inflammation (NO).
哮喘是工业化国家最常见的职业性呼吸系统疾病。在本研究中，我们调查了质量控制图作为一种利用呼气峰值流速（PEF）作为感兴趣变量来探究哮喘与工作相关性的方法的有效性。
记录了几名疑似患有职业性哮喘的工人的PEF测量值。在工作期间记录了2周的测量值，以及在非工作期间的测量值。对于每个受试者，使用休哈特方法绘制并分析了平均[符号：见原文]质量控制图。
利用工作时平均每日PEF昼夜变化与基线平均昼夜变化的比值，质量控制图检测并表征了工作场所期间和非工作场所期间PEF变化的增加。该比值在15%和20%时进行了评估，并与金标准结果进行了比较。比值大于15%时，敏感性为94%，特异性为61%。这些结果与之前发表的工作相当，在某些情况下甚至更好。
质量控制图是一种用于早期干预以检测疑似职业性哮喘工人的有效且廉价的方法。此外，本文的研究结果呼吁使用质量控制图方法对气道阻塞（FEV-1、气道阻力）或炎症（一氧化氮）的其他指标进行职业性哮喘的进一步研究。
