IgE and RAST in diagnosing occupational asthma

I am writing a medico-legal report on a chap who uses strong glue to stick the upholstery to the inside of cars and has developed asthma. His story is good for occupational asthma, as are his Peak flow recordings but his IgE RAST and IgE are negative and normal respectively. This does not put me off the diagnosis, does it you? Could you tell me what weight you but on specific RAST testing and is it worth doing at all ?

Occupational Asthma, Specialist, 10/23/2006, 10/23/2006,

It all depends on the antigen you are looking for. Most latex allergic workers have a positive IgE to a well characterised latex extract. About 20% of workers with isocyanate asthma have a positive RAST to isocyanate-HSA conjugates. Acid anhydrides perform well, colophony and acrylates badly. What is your worker exposed to? In my experience IgE antibodies are only occasionally helpful with occupational asthma due to adhesives.

10/23/2006