Occupational Asthma Reference

Suarthana E, Malo J-L, Heederik D, Ghezzo H, LArchevêque J, Gautrin D, Which tools best predict the incidence of work-related sensitisation and symptoms, Occup Environ Med, 2009;66:111-117,
(Plain text: Suarthana E, Malo J-L, Heederik D, Ghezzo H, LArcheveque J, Gautrin D, Which tools best predict the incidence of work-related sensitisation and symptoms, Occup Environ Med)

Keywords: indonesia, canada, diagnosis, questionnaire, rat, mouse, laboratory animal

Known Authors

Dick Heederik, Institute of Risk Assessment Sciences, Utrecht Dick Heederik

Jean-Luc Malo, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Jean-Luc Malo

Denise Gautrin, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Denise Gautrin

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Abstract

Background/aim: This study used information from the questionnaire alone or in conjunction with clinical tests, such as skin-prick testing (SPT) and bronchial responsiveness (BR) testing at entry, to develop models for estimating the probability of the occurrence of specific IgE-sensitisation to and respiratory symptoms in contact with laboratory animal (LA) allergens after 32 months’ training in an animal health technology programme.

Methods: Four multivariable logistic regression models were developed for each endpoint, consisting of: (1) questionnaire; (2) questionnaire and SPT; (3) questionnaire and BR testing; and (4) questionnaire, SPT and BR testing. The prognostic models were derived from a cohort of Canadian animal health technology apprentices. The models’ internal validity and diagnostic accuracy were evaluated and compared.

Results: Symptoms indicative of asthma and allergic symptoms at baseline composed the final questionnaire model for the occurrence of occupational sensitisation and symptoms. Both questionnaire models showed a good discrimination (area under the receiver operating characteristics curve were 0.73 and 0.78, respectively) and calibration (Hosmer-Lemeshow test p value >0.10). Addition of SPT and/or BR testing increased the specificity of the questionnaire model for LA sensitisation, but not for symptoms at work. To facilitate their application in practice, the final questionnaire models were converted to easy-to-use scoring system.

Conclusions: Questionnaire is an easy tool that can give accurate prediction of the incidence of occupational sensitisation and symptoms.

Plain text: Background/aim: This study used information from the questionnaire alone or in conjunction with clinical tests, such as skin-prick testing (SPT) and bronchial responsiveness (BR) testing at entry, to develop models for estimating the probability of the occurrence of specific IgE-sensitisation to and respiratory symptoms in contact with laboratory animal (LA) allergens after 32 months' training in an animal health technology programme. Methods: Four multivariable logistic regression models were developed for each endpoint, consisting of: (1) questionnaire; (2) questionnaire and SPT; (3) questionnaire and BR testing; and (4) questionnaire, SPT and BR testing. The prognostic models were derived from a cohort of Canadian animal health technology apprentices. The models' internal validity and diagnostic accuracy were evaluated and compared. Results: Symptoms indicative of asthma and allergic symptoms at baseline composed the final questionnaire model for the occurrence of occupational sensitisation and symptoms. Both questionnaire models showed a good discrimination (area under the receiver operating characteristics curve were 0.73 and 0.78, respectively) and calibration (Hosmer-Lemeshow test p value >0.10). Addition of SPT and/or BR testing increased the specificity of the questionnaire model for LA sensitisation, but not for symptoms at work. To facilitate their application in practice, the final questionnaire models were converted to easy-to-use scoring system. Conclusions: Questionnaire is an easy tool that can give accurate prediction of the incidence of occupational sensitisation and symptoms.

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Comments

Score Chart
Predictors in the Model Value Score

Symptoms indicative for asthma
Score 1 if “YES” to at least one of the following questions:

• Have you had wheezing or whistling in the last 12 months?
• Have you had an attack of shortness of breath in the last 12 months?
• Ever diagnosed asthma by physician
• Do you ever start to cough induced by exercise, strenuous work, cold air, heavy smell, smoke, or dust?

Allergic symptoms
Score 2 if “YES” answer to at least one of the following questions:

?? Do you develop eye or nasal or respiratory or skin symptoms when exposed to common allergen such as dust mite, animal hair or pollen?
?? Do you ever have an itchy runny nose or sneezing even when you do not have a cold?
?? Have you ever had "hay fever"?

Risk of sensitisation to laboratory animals after 32 months of training
Sum score 0, 1, 2, 3
0 3%
1 7%
2 18%
3 37%


Symptoms indicative for asthma
Score 1 if “YES” to at least one of the following questions:

• Have you had wheezing or whistling in the last 12 months?
• Have you had an attack of shortness of breath in the last 12 months?
• Ever diagnosed asthma by physician
• Do you ever start to cough induced by exercise, strenuous work, cold air, heavy smell, smoke, or dust?

Allergic symptoms
Score 2 if “YES” answer to at least one of the following questions:

?? Do you develop eye or nasal or respiratory or skin symptoms when exposed to common allergen such as dust mite, animal hair or pollen?
?? Do you ever have an itchy runny nose or sneezing even when you do not have a cold?
?? Have you ever had "hay fever"?

Incidence of symptoms at work in laboratory animals after 32 months of training
Sum score 0, 1, 2, 3
0 1%
1 4%
2 23%
3 44%
3/16/2011

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