{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:55:53Z","timestamp":1790506553714,"version":"4.1.0"},"reference-count":41,"publisher":"BMJ","issue":"7","funder":[{"name":"E.S. is a recipient of the Fonds de recherche du Qu\u00e9bec \u2013 Sant\u00e9 and the Institut de recherche Robert-Sauv\u00e9 en sant\u00e9 et en s\u00e9curit\u00e9 du travail (FRQS-IRSST) Career Award Program"},{"name":"Fondation Auger"},{"name":"P.S-C is a recipient of the FRQS Career Award Program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Of 427 workers who were exposed to high-molecular-weight agents and referred to OA clinic at Montr\u00e9al Sacr\u00e9-C\u0153ur Hospital between 1983 and 2016, we analysed 160 workers who completed non-specific bronchial hyper-responsiveness (NSBHR) tests and still worked 1\u2009month 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final model, which included age \u226440 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 &lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2018-105593","type":"journal-article","created":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T17:16:08Z","timestamp":1555780568000},"page":"495-501","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents"],"prefix":"10.1136","volume":"76","author":[{"given":"Mahsa","family":"Taghiakbari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques-Andr\u00e9","family":"Pralong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-9628","authenticated-orcid":false,"given":"Catherine","family":"Lemi\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Moullec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramita","family":"Saha-Chaudhuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Cartier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Castano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Suarthana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,20]]},"reference":[{"key":"2020050723133499000_76.7.495.1","first-page":"1000","article-title":"Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders","volume":"93","author":"Bepko","year":"2016","journal-title":"Am Fam Physician"},{"key":"2020050723133499000_76.7.495.2","first-page":"122","article-title":"Occupational asthma in the developing and industrialised world: a review","volume":"11","author":"Jeebhay","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"2020050723133499000_76.7.495.3","unstructured":"CNESST. 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