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Hypersensitivity pneumonitis in workers exposed to metalworking fluids
Christopher M Barber1, Clare M Burton, David J Hendrick
1Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK.
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.
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