Predicting positive SIC to high MW agents works best for flour and grain

This paper provides a formula for predicting the results of specific inhalation testing with high molecular weight agents in those occupational exposed within the last month. It weights younger age, exposure to flour/grain rather than other high MW agents, the presence of rhinoconjunctivitis, inhaled corticosteroid use, positive IgE to the occupational agent and the presence of non-specific bronchial reactivity. This is an extension of the work in the 1970's by Bryant and Burns showing that the dose of allergen needed to elicit a bronchial response was related to the presence of specific IgE and the level of bronchial responsiveness, and was lowest in those with asthma, intermediate in those with rhinoconjunctivitis but no asthma, and highest in those with sensitisation only.

References

	Taghiakbari M, Pralong JA, Lemière C, Moullec G, Saha-Chaudhuri P, Cartier A, Castano R, Suarthana E., Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents, Occup Environ Med, 2019;:,10.1136/oemed-2018-105593

	Bryant DH, Burns MW, Bronchial histamine reactivity: its relationship to the reactivity of the bronchi to allergens, Clin Allergy, 1976;6:523-532,

	Bryant DH, Burns MW, The relationship between bronchial histamine reactivity and atopic state, Clin Allergy, 1976;6:373-381,

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