title: Work-Related Asthma.
abstract: OBJECTIVE
  Summarize developed evidence-based diagnostic and treatment guidelines for work-related asthma (WRA).
  
  
  METHODS
  Comprehensive literature reviews conducted with article critiquing and grading. Guidelines developed by a multidisciplinary expert panel and peer-reviewed.
  
  
  RESULTS
  Evidence supports spirometric testing as an essential early test. Serial peak expiratory flow rates measurement is moderately recommended for employees diagnosed with asthma to establish work-relatedness. Bronchial provocation testing is moderately recommended. IgE and skin prick testing for specific high-molecular weight (HMW) antigens are highly recommended. IgG testing for HMW antigens, IgE testing for low-molecular weight antigens, and nitric oxide testing for diagnosis are not recommended. Removal from exposure is associated with the highest probability of improvement, but may not lead to complete recovery.
  
  
  CONCLUSIONS
  Quality evidence supports these clinical practice recommendations. The guidelines may be useful to providers who diagnose and/or treat WRA.
authors.forename: Athena T
authors.initials: AT
authors.lastname: Jolly
authors.forename: Julia E
authors.initials: JE
authors.lastname: Klees
authors.forename: Karin A
authors.initials: KA
authors.lastname: Pacheco
authors.forename: Tee L
authors.initials: TL
authors.lastname: Guidotti
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kipen
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Biggs
authors.forename: Mark H
authors.initials: MH
authors.lastname: Hyman
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Bohnker
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Thiese
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Hegmann
authors.forename: Philip
authors.initials: P
authors.lastname: Harber
mesh_terms: D059366:Asthma, Occupational / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D015415:Biomarkers / Q000378:metabolism; D001985:Bronchial Provocation Tests; D006801:Humans; D012882:Skin Tests; D013147:Spirometry
chemical_list: D015415:Biomarkers