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实验室动物过敏的入职前筛查:其潜在效用的流行病学评估

Preemployment screening for allergy to laboratory animals: epidemiologic evaluation of its potential usefulness.

作者信息

Newill C A, Evans R, Khoury M J

出版信息

J Occup Med. 1986 Nov;28(11):1158-64.

PMID:3783284
Abstract

Employers at laboratory animal facilities have begun to use selection criteria which proscribe employment of persons thought to be at increased risk of developing allergy to laboratory animals. Some of these criteria are: a personal history of allergy, chronic rhinitis, or asthma, positive direct skin tests, elevated serum immunoglobulin E, abnormal forced expiratory volume in 1 second, and a family history of allergy. The usefulness of these criteria were examined in preemployment screening when applied to job applicants who will be handling laboratory animals, by calculating the sensitivity, specificity, and positive predictive value (PPV) of each criterion. Results illustrated that the primary goal of the screening program must be determined before an evaluation can be made of the usefulness of potential screening criteria in meeting the goal, ie, to identify persons who are themselves at high risk (high PPV), to identify a large proportion of low-risk job applicants (specificity), or to screen out a large proportion of occupational disease (high sensitivity), because it is not possible to maximize these parameters simultaneously. Results indicate that, currently, the use of these screening criteria as determinants for hiring persons to work with laboratory animals is unwarranted.

摘要

实验动物设施的雇主已开始采用甄选标准,这些标准禁止雇佣那些被认为对实验动物过敏风险增加的人。其中一些标准包括:过敏个人史、慢性鼻炎或哮喘、皮肤直接试验阳性、血清免疫球蛋白E升高、一秒用力呼气量异常以及过敏家族史。通过计算每个标准的敏感性、特异性和阳性预测值(PPV),在对将处理实验动物的求职者进行入职前筛查时,对这些标准的实用性进行了检验。结果表明,在评估潜在筛查标准在实现目标方面的实用性之前,必须先确定筛查计划的主要目标,即识别自身处于高风险的人员(高PPV)、识别大部分低风险求职者(特异性)或筛查出大部分职业病患者(高敏感性),因为不可能同时最大化这些参数。结果表明,目前,将这些筛查标准用作雇佣与实验动物打交道人员的决定因素是没有根据的。

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