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Hypersensitivity pneumonitis in workers exposed to metalworking fluids
Author(s) -
Barber Christopher M.,
Burton Clare M.,
Hendrick David J.,
Pickering C Anthony C.,
Robertson Alastair S.,
Robertson Wendy,
Burge P Sherwood
Publication year - 2014
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.22337
Subject(s) - medicine , hypersensitivity pneumonitis , gold standard (test) , expert opinion , occupational exposure , intensive care medicine , emergency medicine , lung
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. Am. J. Ind. Med. 57:872–880, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.