title: Hypersensitivity pneumonitis in workers exposed to metalworking fluids.
abstract: BACKGROUND
  This study used data from a large UK outbreak investigation, to develop and validate a new case definition for hypersensitivity pneumonitis due to metalworking fluid exposure (MWF-HP).
  
  
  METHODS
  The clinical data from all workers with suspected MWF-HP were reviewed by an experienced panel of clinicians. A new MWF-HP Score was then developed to match the "gold standard" clinical opinion as closely as possible, using standard diagnostic criteria that were relatively weighted by their positive predictive value.
  
  
  RESULTS
  The new case definition was reproducible, and agreed with expert panel opinion in 30/37 cases. This level of agreement was greater than with any of the three previously utilized case definitions (agreement in 16-24 cases). Where it was possible to calculate, the MWF-HP Score also performed well when applied to 50 unrelated MWF-HP cases.
  
  
  CONCLUSIONS
  The MWF-HP Score offers a new case definition for use in future outbreaks.
authors: Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK.
authors: Christopher M
authors: CM
authors: Barber
authors: Clare M
authors: CM
authors: Burton
authors: David J
authors: DJ
authors: Hendrick
authors: C Anthony C
authors: CA
authors: Pickering
authors: Alastair S
authors: AS
authors: Robertson
authors: Wendy
authors: W
authors: Robertson
authors: P Sherwood
authors: PS
authors: Burge
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D000542:Alveolitis, Extrinsic Allergic / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007219:Industrial Oils / Q000633:toxicity*; D008153:Lubrication; D008297:Male; D008669:Metallurgy / Q000379:methods*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D015203:Reproducibility of Results; D006113:United Kingdom
chemical_list: D000395:Air Pollutants, Occupational
keywords: diagnostic criteria; hypersensitivity pneumonitis; metalworking fluid