Truncating the dose range for methacholine challenge tests: Three occupational studies

Ilir Agalliu, Ellen A. Eisen, Russ Hauser, Carrie A. Redlich, Meredith H. Stowe, Mark R. Cullen, David H. Wegman, David C. Christiani, Susan M. Kennedy

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The methacholine challenge test protocol was assessed in the reanalysis of three occupational studies. We evaluated the impact of truncating the range of methacholine on responsiveness, as defined by slope and PC20. In original analysis, reactivity was similar for apprentices and auto body shop workers, whereas boilermakers were more responsive. Truncating high concentrations did not change the classification of subjects with PC20 < 8 or 16 in any population. However, when responsiveness was measured by slope, the mean responsiveness increased, from -7.9 to -15.3 for apprentices and -7.2 to -10.0 for auto-body shop workers. Results support the American Thoracic Society's recommended maximum of 16 mg/mL and provide evidence that extending the dose range beyond that does not increase sensitivity, whereas stopping before 16 may exaggerate response. Furthermore, to ensure validity, neither slope nor PC20 should be extrapolated beyond data.

Original languageEnglish (US)
Pages (from-to)841-847
Number of pages7
JournalJournal of Occupational and Environmental Medicine
Issue number8
StatePublished - Aug 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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