Objectives-To investigate the incidence of allergy to laboratory animals (ALA) during the first two years of employment, and to study the effect on ALA of atopy and sensitisation. Methods-A follow up prospective study of ALA at the Zeneca (formerly ICI) Research Laboratories. Results-The incidence of the disease during the first year of employment has remained at about 10% since the mid1980s. This compares with an incidence of 37% in the early 1980s. The reduction in incidence and its maintenance at a lower level is thought to be due to the introduction and management of improved engineering controls, working practices, and educational programmes designed to reduce exposure to allergens from laboratory animals. The underlying incidence of immunological sensitisation to animals ( Two of these prospective studies also investigated the influence of one or more atopic indicators on the development of ALA.26 In both of these studies, it was concluded that the exclusion of people with atopy from working with animals could not be justified, as for every case of ALA that would theoretically be prevented, at least three people who would never develop the problem would also be denied employment.At ICI (now Zeneca), since the mid-1980s there has been a coordinated process to try to maintain or reduce further the incidence of ALA by means of improved engineering controls and the use of personal protective equipment as well as by health surveillance and educational programmes. We report one outcome of this, namely the incidence of ALA during the first two years of employment in a group of 200 scientists and technicians recruited by ICI since the last study (from 1987-1990). The paper also considers the influence of atopy and of pre-existing sensitisation to laboratory animals on the development of ALA.

ObjectiveInflammatory bowel disease (IBD) is increasingly managed with the use of biologic therapies. National guidelines (National Institute for Health and Care Excellence (NICE)) suggest considering cessation after 1 year of therapy but lack detailed criteria for this. We aimed to describe clinical outcomes from the introduction of a biologic review panel (BRP) to implement modified criteria for cessation of antitumour necrosis factor (anti-TNF) therapy and step down to single-agent immunomodulator.DesignRetrospective review of patient outcomes following BRP implementation.PatientsAll patients on biologic therapy discussed in the BRP within a 5-year period.SettingSingle IBD network covering three hospital sites.InterventionsModified criteria for biologic cessation were based on published evidence; they excluded individuals with no suitable maintenance immunomodulator, previous surgery or evidence of active disease, additional indications for anti-TNF therapy and previous relapse on biologic cessation. All patients with IBD on a biologic were discussed at the BRP.Main outcome measuresRelapse following IBD cessation and relative cost of BRP.Results136 patients with IBD were reviewed, with 45 patients meeting the NICE guideline criteria for cessation. The BRP and modified criteria affected decision to withdraw therapy in 38% of these. Therapy was withdrawn in 27 patients, with a 20% 24-month relapse rate. Younger age at cessation was significantly associated with relapse (p=0.01).ConclusionThe BRP approach has proved a safe and effective means of decision making in stopping biologic therapy. Future work to inform exclusion criteria is required.

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