Reference

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

57 workers smoked and 29 were atopic; 22 developed a positive result on skin testing with platinum salts and 49 developed symptoms, including all 22 whose skin test result was positive. Smoking was the only significant predictor of a positive result on skin testing with platinum salts and its effect was greater than that of atopy; the estimated relative risks when both were included in the regression model were: smokers versus non-smokers 5.05 and atopic versus non-atopic 2.29. Number of cigarettes smoked per day was the only significant predictor of respiratory symptoms. Smokers were at increased risk of sensitisation by platinum salts and had an increased risk of occupational allergy. Smoking pre-dated allergy, the association was strong and there was a suggestion of a dose-dependent gradient, observations that are consistent with a causal relationship. The risk for atopy was smaller than that for smoking and was not significant after taking account of smoking. People with a history of allergy were not employed in the refinery and thus a few highly susceptible atopic subjects may have been excluded, leading to underestimation of the risk from atopy.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements