Diagnostic testing in occupational asthma

Background: Occupational asthma may often be a challenge to diagnose as the relationship between work and symptoms may not be immediately clear. The p otential consequences for the worker's career make an accurate diagnosis es sential. A history of work-associated asthma symptoms that recede when the patient is not at work is the first clue. Methods: A nonspecific bronchial challenge, most commonly with methacholine , can help confirm the diagnosis of asthma. Specific IgE to suspected agent s can be tested for, preferably with skin testing. Serial monitoring of pea k expiratory flow rate (PEFR) or forced expiratory volume in 1 second (FEV1 ) at work and outside of work can determine if the asthma is occupational i n nature. Conclusion: Specific bronchial challenge to suspected occupational agents i s the gold standard for diagnosis of occupational asthma.