title: Environmental challenge.
abstract: A variety of organic dusts and chemicals encountered in our environment are capable of provoking a response in the lung. Frequently, they produce transient or reversible physiologic changes that may obscure the diagnosis. The patient may fail to recognize a causal relationship with a specific exposure with late-onset reactions and the development of symptoms remote from the exposure. A thorough evaluation of the individual's total environment and symptoms, with particular reference to their time course, is essential in making the diagnosis. Removal of the worker from a suspected environment, with serial clinical and physiologic monitoring to demonstrate improvement, or return to the workplace with similar studies, can be helpful in establishing a causal relationship. When a specific agent can be identified, a controlled inhalation challenge in the laboratory is the procedure of choice. Once a causal relationship has been established, the individual should be removed from exposure or the implicated agent eliminated.
authors.affiliation: Pulmonary Medicine Department, Medical College of Wisconsin, Milwaukee 53226.
authors.forename: D P
authors.initials: DP
authors.lastname: Schlueter
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000209:etiology; D001249:Asthma / Q000209:etiology*; D001716:Bird Fancier's Lung / Q000209:etiology; D001985:Bronchial Provocation Tests / Q000379:methods*; D004391:Dust / Q000009:adverse effects*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D012307:Risk Factors
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust