Variability in the diagnosis of occupational asthma and implications for clinical practice.
OBJECTIVE
The purpose of this review is to provide a summary of recent evidence relating to occupational asthma diagnosis.


RESULTS
Recent evidence suggests that whilst prolonged asthmagen exposure worsens the prognosis, many steps in the diagnostic process are problematic for workers with possible occupational asthma. Certain workers suffer delay prior to specialist assessment, and assessment itself may be of variable quality. Emerging evidence suggests that whilst experts agree about certain aspects of case assessment, there is still likely to be variation in clinical practice. Implications of this variation for the workers assessed are relatively under researched.


CONCLUSIONS
Future research needs to focus not only on improving diagnostic testing, but also on improving consistency and agreement over diagnosis.
Fishwick
David
D
Centre for Workplace Health, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Respiratory Function Unit, Royal Hallamshire Hospital, Sheffield, UK.
Curran
Andrew D
AD
D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003954:Diagnostic Services; D042241:Early Diagnosis; D006306:Health Surveys; D006801:Humans; D015588:Observer Variation; D016273:Occupational Exposure; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards; D012307:Risk Factors; D006113:United Kingdom