Diagnostic testing in occupational asthma.
BACKGROUND
Occupational asthma may often be a challenge to diagnose as the relationship between work and symptoms may not be immediately clear. The potential consequences for the worker's career make an accurate diagnosis essential. A history of work-associated asthma symptoms that recede when the patient is not at work is the first clue.


METHODS
A nonspecific bronchial challenge, most commonly with methacholine, can help confirm the diagnosis of asthma. Specific IgE to suspected agents can be tested for, preferably with skin testing. Serial monitoring of peak expiratory flow rate (PEFR) or forced expiratory volume in 1 second (FEV1) at work and outside of work can determine if the asthma is occupational in nature.


CONCLUSIONS
Specific bronchial challenge to suspected occupational agents is the gold standard for diagnosis of occupational asthma.
Tan
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California Allergy and Asthma Medical Group, Inc. Los Angeles 90025, USA.
Spector
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D000918:Antibody Specificity; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D001985:Bronchial Provocation Tests; D004780:Environment, Controlled; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010366:Peak Expiratory Flow Rate; D012129:Respiratory Function Tests
D007073:Immunoglobulin E