Authors : Aslin Johnsi L.; Dr. Santhi Appavu; Dr. Sheeba Chellappan

Volume/Issue : Volume 10 - 2025, Issue 12 - December

Google Scholar : https://tinyurl.com/yttsbj7f

Scribd : https://tinyurl.com/2nnbpjcm

DOI : https://doi.org/10.38124/ijisrt/25dec1534

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Chronic respiratory illnesses, particularly asthma and chronic obstructive pulmonary disease (COPD), along with occupational lung diseases such as byssinosis, silicosis, and dust-induced airway disorders, constitute a significant global public health burden, with a disproportionate impact on low- and middle-income countries. Early identification of airway obstruction and timely intervention are critical in preventing progressive and irreversible lung damage. The peak flow meter (PFM), a portable instrument used to assess peak expiratory flow rate (PEFR), provides a practical and cost-effective approach for monitoring airway function outside specialized pulmonary laboratories. While spirometry remains the gold standard for pulmonary function testing, serial PEFR monitoring is particularly useful in resource-constrained settings, workplaces, and community-based screening programs. This review outlines the physiological basis of PEFR, measurement techniques, and interpretation; examines its clinical utility in asthma and occupational lung diseases; evaluates advantages and limitations; and highlights the essential role of nursing professionals in patient education, monitoring, and preventive care. Evidence from occupational health research is synthesized to support the use of PEFR in workplace surveillance. Future perspectives, including digital peak flow meters, mobile health integration, and implications for occupational health policy, are also discussed.

Keywords : Peak Flow Meter, PEFR, Asthma, Occupational Lung Disease, Byssinosis, Silicosis, Nursing, Respiratory Monitoring, Workplace Health.

References :

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention: 2024 update. Fontana (WI): Global Initiative for Asthma; 2024.
2. Reeb G, et al. Occupational/work-related asthma medical treatment guideline: peak expiratory flow rates (PEFR). J Occup Environ Med. 2016;58(6): e215–e220.
3. Bandyopadhyay D, Sharma S, Biswas D. Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice. NPJ Prim Care Respir Med. 2017; 27:29. doi:10.1038/s41533-017-0036-8.
4. Moore VC, Jaakkola MS, Burge PS. Use of serial measurements of peak flow in the diagnosis of occupational asthma. Occup Environ Med. 2009;66(7):416–422.
5. New Jersey Department of Health SENSOR Project. The use of portable peak flowmeters in the surveillance of occupational asthma. Am J Ind Med. 1991;19(2):199–206.
6. Moore VC, Jaakkola MS, Burge PS. A systematic review of serial peak expiratory flow measurements in the diagnosis of occupational asthma. Ann Respir Med. 2009;5(2):85–96.
7. Akter MM, Sarka CR, Zahid AZR. Effects of cement dust on peak expiratory flow rate among female cement dust–exposed construction workers. J Rangpur Med Coll. 2023;8(2):25–28. doi:10.3329/jrpmc. v8i2.69322.
8. Singh SK, Chowdhary GR, Purohit G. Assessment of impact of high particulate concentration on peak expiratory flow rate of lungs of sandstone quarry workers. Int J Environ Res Public Health. 2006;3(4):355–359. doi:10.3390/ijerph2006030046.
9. Deshmukh SA, Nigudgi SR, Reddy S. Peak expiratory flow rate among workers engaged in stone crushing units surrounding Gulbarga city. Int J Community Med Public Health. 2015;2(4):547–552. doi:10.18203/2394-6040.ijcmph20150680.
10. Ebeling TR, Hankinson JL, Lyman M, Petsonk EL, Short SR, Viola JO. Investigation of work-related respiratory symptoms using portable battery-operated belt spirometry. NIOSH Tech Rep. 1994; 94:101–110.
11. Cockcroft DW, et al. Use of peak flow meters in the monitoring of airflow limitation: principles and limitations. J Occup Med. 1989;31(5):395–401.
12. Nunn AJ, Gregg I. Outcome of patients with borderline airflow obstruction: comparison of peak flow meter and spirometry. Thorax. 1989;44(2):96–100.
13. Burge PS, et al. Peak flow rate records in the diagnosis of occupational asthma due to isocyanates. Am Rev Respir Dis. 1991;143(6):1316–1321.
14. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–968.
15. Viegi G, Paoletti P, Renzetti G, et al. Peak expiratory flow standards in Italian adults aged 25–84 years. Eur Respir J. 2004;23(3):389–396.
16. Hnizdo E, Murray J. Cumulative exposure to silica dust and risk of chronic airway obstruction. Occup Environ Med. 1998;55(3):234–240.
17. American Thoracic Society. Standardization of spirometry: 1994 update. Am J Respir Crit Care Med. 1995;152(3):1107–1136.
18. American College of Occupational and Environmental Medicine (ACOEM). Occupational respiratory disease guidelines. Elk Grove Village (IL): ACOEM; 2022.