Occupational Medicine 2007;57:388 doi:10.

1093/occmed/kqm051

MRC questionnaire (MRCQ) on respiratory symptoms

A brief history
The Medical Research Council Questionnaire (MRCQ) was developed by researchers at the Medical Research Council, UK, as a tool to study respiratory epidemiology in communities and occupational groups [1]. It reliably relates symptoms and lung function and has been in use for almost 50 years. The 1976 version is reproduced in a current publication [2]. Instructions on its use can be obtained from the authors. A subsequent version includes questions that are directed to identifying asthma [3]. These two features appear to be co-linear and this possibility should be explored further.

Key research
The MRCQ is recommended for use in epidemiological and occupational respiratory surveys and as part of a consultation for respiratory symptoms or assessment of lung function. Where appropriate, the screening can be expanded with additional questions on ischaemic heart disease [8], asthma [9] or exposure to occupational respiratory hazards such as coal or cotton dust, asbestos bres or fumes from welding [10]. J. E.Cotes1 and D. J. Chinn2

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Items
In its usual form, the MRCQ comprises 17 questions on respiratory symptoms (cough, phlegm, breathlessness, wheeze and chest illnesses, now and during the past 2 years), detailed questions on smoking history and a check-list on past illnesses.

References
1. Medical Research Council on the Aetiology of Chronic Bronchitis. Standardised questionnaire on respiratory symptoms. Br Med J 1960;2:1665. 2. Cotes JE, Chinn DJ, Miller MR. Lung Function: Physiology Measurement and Application in Medicine: 6th ed. Oxford Blackwell Publishing 2006;8791. 3. Cotes JE. Medical Research Council Questionnaire on respiratory symptoms. Correspondence. Lancet 1987;2: 1028. 4. Field GB. The application of a quantitative estimate of cough frequency to epidemiological surveys. Int J Epidemiol 1974;3:135143. 5. Medical Research Council. Denition and classication of chronic bronchitis for clinical and epidemiological purposes. Lancet 1965;1:775779. 6. Cotes JE, Zejda J, King B. Lung function impairment as a guide to exercise limitation in work-related lung disorders. Am Rev Respir Dis 1988;137:10891093. 7. Jones PW. Quality of life measurement for patients with diseases of the airways. Thorax 1991;46:676. 8. Rose G, McCartney P, Reid DD. Self-administration of a questionnaire on chest pain: intermittent claudication. Brit J Prev Soc Med 1977;31:4248. 9. Burney P, Chinn S. Developing a new questionnaire for measuring the prevalence and distribution of asthma. Chest 1987;91(Suppl.):79S83S. 10. Chinn DJ, Cotes JE, El-Gamal FM et al. Respiratory health of young shipyard welders and other tradesmen studied cross-sectionally and longitudinally. Occup Environ Med 1995;55:3342.

Validity
Wording of questions, follow-up questions, denitions and interpretation of responses are standardized and alternative questions have been prepared for special circumstances, for example, shift working. The intensity of symptoms is not covered but can be scored separately [4]. The MRCQ provides a system for scoring respiratory symptoms [5] and identifying underlying factors including smoking, previous chest illnesses and occupational dusts and vapours. Reproducibility is achieved by having the questions asked by an observer who had previously used the training manual and cassette. However, a version for self-administration is also available. The questions on breathlessness are widely used for grading this symptom, but there is more than one scoring system, so the grades should be dened. In subjects with chronic respiratory disorders, the grades of breathlessness are weakly correlated with forced expiratory volume (FEV1). However, the correlation is higher with ventilation during sub-maximal exercise [6] and with quality of life as assessed by a quality of life questionnaire [7].
1 2

School of Health Science, University of Durham, Durham, UK.

Department of Community Health Sciences, University of Edinburgh, Edinburgh, UK. Correspondence to: e-mail: MRCQ@coterie.globalnet.co.uk

The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org