Application of a prediction model for work-related sensitisation in bakery workers.
Identification of work-related allergy, particularly work-related asthma, in a (nationwide) medical surveillance programme among bakery workers requires an effective and efficient strategy. Bakers at high risk of having work-related allergy were indentified by use of a questionnaire-based prediction model for work-related sensitisation. The questionnaire was applied among 5,325 participating bakers. Sequential diagnostic investigations were performed only in those with an elevated risk. Performance of the model was evaluated in 674 randomly selected bakers who participated in the medical surveillance programme and the validation study. Clinical investigations were evaluated in the first 73 bakers referred at high risk. Overall 90% of bakers at risk of having asthma could be identified. Individuals at low risk showed 0.3-3.8% work-related respiratory symptoms, medication use or absenteeism. Predicting flour sensitisation by a simple questionnaire and score chart seems more effective at detecting work-related allergy than serology testing followed by clinical investigation in all immunoglobulin E class II-positive individuals. This prediction based stratification procedure appeared effective in detecting work-related allergy among bakers and can accurately be used for periodic examination, especially in small enterprises where delivery of adequate care is difficult. This approach may contribute to cost reduction.
Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Jenalaan 18d, 3584 CK, Utrecht, The Netherlands. e.meijer@uu.nl
E
E
Meijer
E
E
Suarthana
J
J
Rooijackers
D E
DE
Grobbee
J H
JH
Jacobs
T
T
Meijster
J G R
JG
de Monchy
E
E
van Otterloo
F G B G J
FG
van Rooy
J J G
JJ
Spithoven
V A C
VA
Zaat
D J J
DJ
Heederik
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000209:etiology / Q000276:immunology*; D005433:Flour; D019649:Food Industry; D006969:Hypersensitivity, Immediate / Q000209:etiology / Q000276:immunology*; D009784:Occupational Diseases / Q000175:diagnosis*; D016273:Occupational Exposure; D016272:Occupational Health; D012306:Risk; D011795:Surveys and Questionnaires; D014937:Work
D000485:Allergens