A Novel Questionnaire and Algorithm for Work-Related Asthma Screening and Surveillance: An EAACI Task Force Report.

Abstract

Work-related exposures contribute to one in six new-onset adult asthma cases and exacerbation of one in five existing cases, which together are termed 'work-related asthma' (WRA). A valid and standardized WRA questionnaire is needed for workplace surveillance and epidemiological studies. This project aimed to review evidence on WRA questionnaires and algorithms to propose a standardized instrument. A scoping review was conducted using PubMed, Embase, and Cochrane databases up to March 2021. Search terms focused on asthma, occupational diseases, questionnaires, surveys, and algorithms. High-quality studies were identified and data extracted on instrument construction, validation, and performance. Common questions were used to develop a questionnaire and algorithm for detecting suspected WRA. Six studies were included. The final WRA questionnaire consists of eight questions on general asthma symptoms, diagnosis, and medication; four on WRA symptoms; and two on work-related ocular-nasal symptoms. The algorithm calculates a WRA total score (WRATS) based on the general asthma and work-related symptoms. A score of ≥ 1 triggers a referral for further evaluation. This is the first WRA questionnaire based on validated questionnaires. Evaluation of its performance and validation in diverse geographic and occupational settings are needed for further refinement and translation for broader applications.