title: Prick testing with chemicals in the diagnosis of occupational contact urticaria and respiratory diseases.
abstract: BACKGROUND
  Little is known about the use of prick tests with chemicals in diagnosing occupational diseases.
  
  
  OBJECTIVE
  To evaluate the use of prick tests in the diagnosis of occupational contact urticaria, asthma and rhinitis caused by chemicals (undertaken at the Finnish Institute of Occupational Health).
  
  
  METHODS
  We retrospectively reviewed the patient and test files for the period 1 January 1991 to 31 May 2011. Prick tests were performed with chemical solutions and human serum albumin (HSA)-chemical conjugates.
  
  
  RESULTS
  Positive prick test reactions to isocyanate-HSA conjugates were associated with isocyanate-specific IgE in all 20 patients, and 17 patients had a relevant occupational disease. Positive reactions to chloramine-T-HSA conjugates in 10 patients also indicated the presence of specific IgE, although occupational diseases were not always diagnosed. Eleven of 17 patients with positive reactions to persulfate solutions were diagnosed with an occupational disease. Methacrylates, colophonium-related substances, amine hardeners, ethanolamines, glutaraldehyde, glyoxal, pyrocatechol and ammonium thioglycolate did not elicit any relevant prick test reactions. No generalized reactions were detected.
  
  
  CONCLUSIONS
  Prick tests can be safely used for diagnosing contact urticaria, asthma and rhinitis caused by isocyanates, chloramine-T, persulfates, and chlorhexidine, but the results should be carefully interpreted and related to clinical symptoms and other diagnostic tests.
authors.affiliation: Occupational Medicine, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland; Department of Public Health, Hjelt Institute, University of Helsinki, PO Box 41, Mannerheimintie 172, 00014, Helsinki, Finland.
authors.forename: Eva
authors.initials: E
authors.lastname: Helaskoski
authors.forename: Hille
authors.initials: H
authors.lastname: Suojalehto
authors.forename: Outi
authors.initials: O
authors.lastname: Kuuliala
authors.forename: Kristiina
authors.initials: K
authors.lastname: Aalto-Korte
mesh_terms: D001249:Asthma / Q000139:chemically induced / Q000175:diagnosis*; D002700:Chloramines / Q000009:adverse effects; D002710:Chlorhexidine / Q000009:adverse effects; D003877:Dermatitis, Contact / Q000175:diagnosis* / Q000209:etiology; D009783:Dermatitis, Occupational / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D017953:Isocyanates / Q000009:adverse effects; D012189:Retrospective Studies; D012220:Rhinitis / Q000139:chemically induced / Q000175:diagnosis*; D012882:Skin Tests; D013431:Sulfates / Q000009:adverse effects; D014105:Tosyl Compounds / Q000009:adverse effects; D014581:Urticaria / Q000139:chemically induced / Q000175:diagnosis*
chemical_list: D002700:Chloramines; D017953:Isocyanates; D013431:Sulfates; D014105:Tosyl Compounds; C016300:chloramine-T; D002710:Chlorhexidine
keywords: chloramine-T; chlorhexidine; epoxy resin; human serum albumin conjugates; isocyanates; persulfates; specific IgE