VALIDITY OF SUBJECTIVE ASSESSMENT OF CHANGES IN RESPIRATORY HEALTH-STATUS - A 30 YEAR EPIDEMIOLOGIC-STUDY OF WORKERS IN PARIS

The validity of scales used for subjective assessment of health, parti cularly transitional indices, is under discussion, The aim of the pres ent study was to assess the concurrent and predictive validity of a si mple estimate of long-term subjective assessment of respiratory health changes, A longitudinal study of 915 workers was conducted over 30 yr s, with both retrospective self-assessment of respiratory health chang es and objective measurements of spirometric values 12 yrs apart. An a ssessment of the reason for death during the subsequent 20 yrs was per formed, Subjective assessment of respiratory deterioration over 12 yrs was significantly related to both cross-sectional lung function value s and longitudinal lung function changes (forced expiratory volume in one second (FEV1) decline), an association which remained after adjust ment for FEV1 level, It was also related to the same risk factors as d ecline in FEV1 (smoking, occupational exposure), Self-evaluation of re spiratory deterioration was significantly predictive of death from all causes, with the highest (but nonsignificant) rate ratio for respirat ory causes. Asthmatics exhibited greater long-term variability (object ive and subjective) than nonasthmatics, Independent of dyspnoea, self- assessment of respiratory health deterioration was significantly relat ed to FEV1, Subjective assessment of long-term changes in respiratory health provides valid information.