Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents.

Details

Serval ID
serval:BIB_6C2735312AEC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents.
Journal
Occupational and environmental medicine
Author(s)
Taghiakbari M., Pralong J.A., Lemière C., Moullec G., Saha-Chaudhuri P., Cartier A., Castano R., Suarthana E.
ISSN
1470-7926 (Electronic)
ISSN-L
1351-0711
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
76
Number
7
Pages
495-501
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Specific inhalation challenge (SIC) as the reference diagnostic test for occupational asthma (OA) is not widely available worldwide. We aimed to develop non-SIC-based models for OA.
Of 427 workers who were exposed to high-molecular-weight agents and referred to OA clinic at Montréal Sacré-Cœur Hospital between 1983 and 2016, we analysed 160 workers who completed non-specific bronchial hyper-responsiveness (NSBHR) tests and still worked 1 month before SIC. OA was defined as positive SIC. Logistic regression models were developed. The accuracy of the models was quantified using calibration and discrimination measures. Their internal validity was evaluated with bootstrapping procedures. The final models were translated into clinical scores and stratified into probability groups.
The final model, which included age ≤40 years, rhinoconjunctivitis, inhaled corticosteroid use, agent type, NSBHR, and work-specific sensitisation had a reasonable internal validity. The area under the receiver operating characteristics curve (AUC) was 0.91 (95% CI 0.86 to 0.95), statistically significantly higher than the combination of positive NSBHR and work-specific sensitisation (AUC=0.84). The top 70% of the clinical scores (ie, the high probability group) showed a significantly higher sensitivity (96.4%vs86.9%) and negative predictive value (93.6%vs84.1%) than the combination of positive NSBHR and work-specific sensitisation (p value <0.001).
We developed novel scores for OA induced by high-molecular-weight agents with excellent discrimination. It could be helpful for secondary-care physicians who have access to pulmonary function test and allergy testing in identifying subjects at a high risk of having OA and in deciding on appropriate referral to a tertiary centre.
Keywords
Administration, Inhalation, Adrenal Cortex Hormones/therapeutic use, Adult, Asthma, Occupational/diagnosis, Conjunctivitis, Female, Forced Expiratory Volume/drug effects, Humans, Logistic Models, Male, Occupational Exposure/adverse effects, Quebec, Retrospective Studies, Rhinitis, Time Factors, asthma, clinical scores, diagnostic model, logistic regression, occupational sensitizers
Pubmed
Web of science
Create date
09/07/2019 11:24
Last modification date
28/02/2020 6:19
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