Occupational Asthma Reference

Barber CM, Burton CM, Hendrick DJ, Pickering CA, Robertson AS, Robertson W, Burge PS, Hypersensitivity pneumonitis in workers exposed to metalworking fluids, Am J Industr Med, 2014;57:872-880,10.1002/ajim.22337

Keywords: diagnostic criteria; hypersensitivity pneumonitis; metalworking fluid, UK,alveolitis,EAA, method

Known Authors

Tony Pickering, Wythenshawe Hospital, Manchester, UK Tony Pickering

Sherwood Burge, Oasys Sherwood Burge

Alastair Robertson, Selly Oak Hospital Alastair Robertson

Wendy Robertson, Public Health, Warwick University Wendy Robertson

David Hendrick, Newcastle-upon-Tyne David Hendrick

Chris Barber, Health and Safety Laboratories, Buxton Chris Barber

Clare Burton, Sheffield University and HSL Buxton Clare Burton

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Abstract

BACKGROUND:
This study used data from a large UK outbreak investigation, to develop and validate a new case definition for hypersensitivity pneumonitis due to metalworking fluid exposure (MWF-HP).

METHODS:
The clinical data from all workers with suspected MWF-HP were reviewed by an experienced panel of clinicians. A new MWF-HP Score was then developed to match the "gold standard" clinical opinion as closely as possible, using standard diagnostic criteria that were relatively weighted by their positive predictive value.

RESULTS:
The new case definition was reproducible, and agreed with expert panel opinion in 30/37 cases. This level of agreement was greater than with any of the three previously utilized case definitions (agreement in 16-24 cases). Where it was possible to calculate, the MWF-HP Score also performed well when applied to 50 unrelated MWF-HP cases.

CONCLUSIONS:
The MWF-HP Score offers a new case definition for use in future outbreaks.

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