COST EFFECTIVE SURVEILLANCE

Although screening is widely advocated for workers at risk of occupational asthma, there are few data on the effectiveness and costs of surveillance. Direct evidence on benefits is costly and hard to collect. Wild et al¹ propose the alternative of model based mathematical simulation, taking as their example isocyanate induced asthma. They compare annual surveillance with passive case finding in terms of various outcomes—symptom-free days, quality adjusted life years (QALY), direct costs, productivity losses, and incremental cost effectiveness ratio (CER). Using input data from a variety of published sources, the authors estimate that 638 cases of disability may be prevented by the 10 year surveillance …