Workplace challenge tests are a gold standard for diagnosis of work-related asthma. A highly accurate portable electronic spirometer is needed to facilitate research and clinical diagnosis. Detailed specifications were developed, including adherence to ATS spirometry recommendations, an algorithm to collect basic data on workers' activities regardless of shift, and incorporation of an investigator-defined questionnaire. The instrument passed all ATS waveforms when tested at NIOSH. Features include: user feedback on maneuver quality; storage of flow-volume curves and parameters for the three best blows within session; pre- and post-bronchodilator test capability; and award of incentive points. The data can be downloaded via modem. The algorithms were tested with simulated work schedules and by workers with asthma. The algorithm collects activity information necessary for analysis in the OASYS-2 software package. Data is stored in Microsoft Access format. Standard diagnostic software was successfully modified to adapt a lightweight highly accurate portable spirometer for use in occupational respiratory epidemiology. The final software is accurate, user-friendly, and customizable to various research settings. Use of the small lightweight portable hand-held spirometer enables researchers and health care professionals to observe workers, in their workplace and home environments over a period of weeks, to establish work-related asthma status.
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