Guidelines for the diagnosis of occupational asthma. Subcommittee on 'Occupational Allergy' of the European Academy of Allergology and Clinical Immunology

Abstract

The 'Guidelines for the diagnosis of Occupational Asthma' have been written by the Subcommittee on Occupational Allergy of the European Academy of Allergology and Clinical Immunology to give common diagnostic criteria in the evaluation of individual patients with suspected occupational asthma. The suggested diagnostic procedure includes five steps. 1. History suggestive of occupational asthma. 2. Confirmation of bronchial asthma, with demonstration of reversibility of bronchial obstruction, of non-specific bronchial hyperreactivity and of increased diurnal variability of peak expiratory flow rates (PEFR). 3. Confirmation of work-related bronchoconstriction with serial measurements of PEFR and of non-specific bronchial reactivity. 4. Confirmation of sensitization to occupational agents with skin tests and/or in vitro tests to detect specific immunoglobulins. 5. Confirmation of causal role of occupational agent with specific bronchial challenges. Requirements, advantages and limitations are discussed for each of the suggested techniques.