Taghiakbari et al reported a clinical score for occupational asthma associated with high-molecular-weight compounds. The authors are from Hopital du Sacre-Coeur de Montreal, Institute for Work and Health (Switzerland) and Universite de Montreal.
Patient selection: worker exposed to high molecular weight agents
Parameters:
(1) age in years
(2) rhinoconjunctivitis symptoms
(3) inhaled corticosteroid usage
(4) agent type
(5) sensitization to work-specific allergens
(6) non-specific bronchial hyperresponsiveness (concentration of methacholine needed to produce a 20% fall in FEV1 from baseline <= 16 mg/mL)
Parameter
Finding
Points
age in years
<= 40
8
> 40
0
rhinoconjunctivitis symptoms
absent
0
present
33
inhaled corticosteroid usage
no
0
yes
20
agent type
flour and associated agents
61
other
0
sensitization to work-specific allergens
negative
0
positive
100
nonspecific bronchial hyperresponsiveness
negative
0
positive
80
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 302
• The higher the score the greater the risk of occupational asthma.
Total Score
Occupational Asthma
0
1%
80
5%
100
9%
120
14%
141
22%
161
33%
180
45%
200
58%
221
71%
241
81%
261
88%
282
92%
302
95%
Performance:
• The area under the ROC curve is 0.91.
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