Which tools best predict the incidence of work-related sensitisation and symptoms.
OBJECTIVE
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.
Suarthana
E
E
Department of Chest Medicine, Hôpital du Sacré-Coeur de Montreal, 5400 West Gouin Blvd, Montreal, Canada H4J 1C5.
Malo
J-L
JL
Heederik
D
D
Ghezzo
H
H
L'Archevêque
J
J
Gautrin
D
D
D000293:Adolescent; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D000830:Animals, Laboratory / Q000276:immunology*; D001985:Bronchial Provocation Tests; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D017056:Medical Laboratory Personnel / Q000193:education*; D015233:Models, Statistical; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects; D011379:Prognosis; D012044:Regression Analysis; D012130:Respiratory Hypersensitivity / Q000209:etiology; D012307:Risk Factors; D012882:Skin Tests; D055815:Young Adult
D000485:Allergens