[Drug allergy: new methodological approaches in occupational clinical evaluations]

Drug reactions in pharmaceutical industry workers represent a quiet different problem in terms of evaluation and job ability, if related to hospitalized patients with adverse reaction to drug administration. The modern approach of GRADE (Grading Recommendation Assessment Development and Evaluation) was applied to 8 workers who had suspected occupational drug reactions, and were clinically examined in order to exclude any possible adverse event. Such a method allows to draw the relationship between adverse reaction to drugs, aetiology, risk evaluation and clinical events. Therefore, the adverse events are classified in type A (incongruous exposure), type B (hypersensitivity reactions) and not A not B (not work related). Both medical history/clinical evaluation and GRADE seem to give a correct view of the single case. Moreover, a high score suggests an occupational pathology, whilst low scores for evidence of drug reaction and occupational risk can avoid the use of diagnostic procedures.