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Which tools best predict the incidence of work-related sensitisation and symptoms
  1. E Suarthana1,2,3,
  2. J-L Malo1,
  3. D Heederik2,
  4. H Ghezzo1,
  5. J L’Archevêque1,
  6. D Gautrin1
  1. 1
    Department of Chest Medicine, Hopital du Sacre-Coeur de Montreal, 5400 West Gouin Blvd, Montreal, Canada H4J 1C5
  2. 2
    IRAS (Institute for Risk Assessment Sciences), Environmental Epidemiology Division, Utrecht University. Utrecht, The Netherlands
  3. 3
    Community Medicine Department, Faculty of Medicine, University of Indonesia. Jl. Pegangsaan Timur 16, 10320, Jakarta Pusat, Indonesia
  1. Dr Denyse Gautrin, Department of Chest Medicine, Hôpital du Sacré-Coeur de Montreal, 5400 West Gouin Blvd, Montreal, Canada H4J 1C5; d.gautrin{at}umontreal.ca

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.

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Footnotes

  • ▸ Appendices are published online only at http://oem.bmj.com/content/vol66/issue2

  • Competing interests: None.

  • Ethics approval: Informed consent was obtained from each subject and the study was performed after approval from the Sacre-Coeur Hospital’s ethics committee in accordance with Canadian ethical rules.

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