Respiratory symptom reporting error in occupational surveillance of older farmers

• Published in: Journal of occupational and environmental medicine Vol. 51; no. 4; p. 472
• Main Authors: Johnson, Nancy E, Browning, Steven R, Westneat, Susan M, Prince, T Scott, Dignan, Mark B
• Format: Journal Article
• Language: English
• Published: United States 01.04.2009
• Subjects: Aged; Agricultural Workers' Diseases - diagnosis; Agricultural Workers' Diseases - epidemiology; Humans; Kentucky - epidemiology; Lung Diseases, Obstructive - diagnosis; Lung Diseases, Obstructive - epidemiology; Male; Middle Aged; Population Surveillance - methods; Prevalence; Risk Factors; Spirometry; Kentucky
• ISSN: 1536-5948
• DOI: 10.1097/JOM.0b013e3181973de5

Agricultural health studies often use respiratory symptom report as a surrogate measure of disease and exposure; little data exists on the accuracy of symptom report in a work-motivated population. Screening spirometry and telephone survey data for Kentucky male farmers >55 year (n = 134) in the NIOSH Farm Family Health and Hazard Surveillance Project were compared to investigate the accuracy of symptom report as a measure of respiratory disease risk in older farmers. The prevalence of reported obstructive respiratory symptoms was 0.24 (95% CI = 0.17 to 0.31); objective measures increased prevalence to 0.35 (95% CI = 0.27 to 0.43). Customary symptom questions did not reliably reflect objective indicators of respiratory impairment. Older farmers may not accurately report respiratory symptoms. Whether by intention or misinterpretation of physical cues, self-reporting errors in this population may introduce misclassification bias.