ORIGINAL ARTICLE

A strategy for health surveillance in laboratory animal workers exposed to high molecular weight allergens

E Meijer¹, D E Grobbee², D Heederik¹

¹ IRAS, Institute for Risk Assessment Sciences, Division Environmental and Occupational Health, Utrecht University, PO Box 80176, 3508 TD, Utrecht, Netherlands
² Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands

Correspondence to:
Correspondence to:
Dr E Meijer
IRAS, Institute for Risk Assessment Sciences, Division Environmental and Occupational Health, Utrecht University, PO Box 80176, 3508 TD, Utrecht, Netherlands; E.Meijer{at}iras.uu.nl

Aims: To develop a health surveillance strategy with the use of diagnostic and prognostic prediction models to detect and predict occupational allergic diseases efficiently.

Methods: Data from laboratory animal workers (n = 351) participating in an ongoing cohort study were used to develop diagnostic and prognostic models with logistic regression analyses. A diagnostic model was developed from questionnaire items, and exposure measurements to find predictors for the estimation of the probability of sensitisation to workplace allergens. With the resulting questionnaire model workers were divided into subgroups (high/low probability). A prognostic model was established in workers initially low sensitised using follow up data over a 2–3 year period. The accuracy of the models was evaluated by the concordance (c) statistic, and by comparison of the predicted and observed prevalence.

Results: A diagnostic rule, containing five questionnaire items, identified workers with a high risk of sensitisation. These workers showed high rates of work related asthma, allergic symptoms, doctor’s visit, and absenteeism. A prognostic rule based on four questionnaire items predicted workers at high risk of near future sensitisation with high rates of future (allergic) respiratory symptoms, and asthmatic attacks.

Conclusion: The risk of (future) sensitisation and the severity of laboratory animal allergy can be predicted accurately with diagnostic and prognostic prediction models based on questionnaire items. Workers with an increased risk of future sensitisation also showed serious allergic symptoms at follow up. Workers with a low risk have a low risk of becoming diseased in the future.

Abbreviations: HMW, high molecular weight; LAA, laboratory animal allergens; RUA, rat urinary aeroallergen; MUA, mouse urinary aeroallergen; SPT, skin prick test; ROC, receiver operator characteristic; AHR, airways hyperresponsiveness; CI, confidence interval

Keywords: health surveillance; questionnaire; prediction models; occupational allergy; laboratory animals

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Work in brief

Dana Loomis
Occup. Environ. Med. 2004 61: 797. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Suarthana, E., Meijer, E., Grobbee, D. E, Heederik, D. (2009). Predicting occupational diseases. Occup. Environ. Med. 66: 713-714 [Full Text]  
• Suarthana, E, Malo, J-L, Heederik, D, Ghezzo, H, L'Archeveque, J, Gautrin, D (2009). Which tools best predict the incidence of work-related sensitisation and symptoms. Occup. Environ. Med. 66: 111-117 [Abstract] [Full Text]  
• MEIJSTER, T., TIELEMANS, E., PATER, N. D., Heederik, D. (2007). Modelling Exposure in Flour Processing Sectors in The Netherlands: a Baseline Measurement in the Context of an Intervention Program. ANN OCCUP HYG 51: 293-304 [Abstract] [Full Text]  
• Mapp, C. E., Boschetto, P., Maestrelli, P., Fabbri, L. M. (2005). Occupational Asthma. Am. J. Respir. Crit. Care Med. 172: 280-305 [Abstract] [Full Text]