COMPARISON OF IMMUNOLOGICAL TESTS IN THE DIAGNOSIS OF OCCUPATIONAL ASTHMA AND RHINITIS

In this study, three immunologic tests, skin prick test, RAST, and bas ophil histamine-release test (BHRT), were compared by provocation in t he diagnosis of occupational asthma and rhinitis. Twenty-three positiv e bronchial or nasal challenges were performed on 16 patients (six far mers, six bakery workers, and four food industry workers) and asthma o r rhinitis was diagnosed as caused by cereal flour or grain, cow epith elium, storage mites, garlic, or soy dust. A control group consisted o f 12 patients, of whom four (two bakery workers, one food industry wor ker, and one farmer) were challenge-negative, and the rest suffered fr om pollen allergy and seasonal rhinitis and were not challenged. The s ensitivity and specificity of the prick test, RAST, BHRT, and a panel of them were as follows: 74 and 89%, 57 and 86%, 78 and 93%, and 91 an d 71%, respectively. The overall concordance among these three type I allergy tests or between immunologic tests and challenge was relativel y good.