Advances in methods used in evaluation of occupational asthma.
OBJECTIVE
Diagnosing occupational asthma (OA) is a complex undertaking, the primary goal of which is to demonstrate a causal relation between exposure to a specific agent encountered at work and asthmatic responses. Recent development or refinement of diagnostic tools may improve the diagnostic accuracy, which may have important economic and social consequences for both employers and workers.


RESULTS
Although specific inhalation challenge (SIC) testing is the gold standard for diagnosis of OA, these tests are not widely available in many countries. Thus, new less invasive techniques used in the measurement of airway inflammation, such as exhaled nitric oxide and induced sputum are highlighted as are recent developments in both in vivo and in vitro immunologic testing.


CONCLUSIONS
Although new perspectives are being evaluated, the diagnosis of occupational asthma still relies mostly on specific inhalation challenge. Further studies are required to confirm the utility of these new techniques in the diagnosis of OA.
Campo
Paloma
P
Division of Immunology-Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Lummus
Zana L
ZL
Bernstein
David I
DI
D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D003948:Diagnostic Techniques, Respiratory System; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007159:Immunologic Tests; D009569:Nitric Oxide / Q000032:analysis; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012882:Skin Tests; D013183:Sputum / Q000166:cytology
D009569:Nitric Oxide; D007073:Immunoglobulin E