title: Risk assessment in determining systemic reactivity to honeybee stings in beekeepers.
abstract: BACKGROUND
  The use of laboratory tests as a reliable method for risk assessment in determining the systemic reactivity of beekeepers to honeybee stings has proven unsatisfactory.
  
  
  OBJECTIVE
  This study was conducted to evaluate the usefulness of a structured questionnaire as a supplement to bee venom-specific IgE data in the prediction of systemic sting reactions of 78 beekeepers to honeybee stings.
  
  
  METHODS
  Participants in previous studies completed a questionnaire concerning potential risk factors of systemic sting reactions. Serum bee venom IgE was measured by CAP-RAST. Skin prick tests were performed with standardized bee venom extracts prior to the beekeeping season. Venom challenges were performed using unintentional field stings. A new questionnaire concerning sting reactions during the recent beekeeping season was sent to the beekeepers after it had ended. A multiple logistic regression analysis was done to evaluate the influence of potential risk factors upon systemic bee sting reactions.
  
  
  RESULTS
  Four variables were significant. The pre-season presence of serum bee venom-specific IgE at concentrations exceeding 1.0 kU/L increased the risk of systemic reactions 12-fold. The risk was 10-fold if nasal or respiratory symptoms had occurred while working at hives. When the years spent in beekeeping were fewer than eight the risk of systemic sting reaction was 9-fold, any previous systemic reaction increased the risk 8-fold.
  
  
  CONCLUSIONS
  The use of more detailed patient histories in combination with laboratory tests may markedly improve the reliability of risk assessment.
authors.affiliation: Department of Pulmonary Diseases, Tampere University Hospital, Finland.
authors.forename: I T
authors.initials: IT
authors.lastname: Annila
authors.forename: P A
authors.initials: PA
authors.lastname: Annila
authors.forename: P
authors.initials: P
authors.lastname: Mörsky
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000276:immunology; D000818:Animals; D001514:Bee Venoms / Q000276:immunology*; D001516:Bees; D006801:Humans; D007299:Insect Bites and Stings / Q000453:epidemiology / Q000276:immunology*; D011852:Radioallergosorbent Test; D012130:Respiratory Hypersensitivity / Q000276:immunology; D018570:Risk Assessment; D012720:Severity of Illness Index; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D001514:Bee Venoms