Hypersensitivity pneumonitis in workers exposed to metalworking fluids.

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.

Recognition and surveillance of occupational asthma: a preventable illness with missed opportunities.

Occupational asthma is common, disabling and costly, and it is often difficult to diagnose. Incidence statistics are consequently unreliable, and there are formidable difficulties in recognizing and managing what should be a preventable illness. The opportunities have largely been missed.

Discordance between cross-sectional and longitudinal studies for the effect of dust on COPD: why?

Regression analyses for the effect of an environmental agent on lung function often give discordant results when derived from cross-sectional compared with longitudinal studies. To evaluate why this occurs, a normal population was created by computer, and modeled to simulate functional change during life. Thus, factors known to influence lung function measurement (including those that may cause COPD) were manipulated experimentally so that their contributions to any discordance could be assessed.