Occupational Asthma Reference

Suojalehto H, Suuronen K, Cullinan P, Specific challenge testing for occupational asthma: revised handbook, Eur Respir J, 2019;54:1901026,10.1183/13993003.01026-2019

Keywords: SIC, ch, methods, review,

Known Authors

Paul Cullinan, Royal Brompton Hospital, London, UK Paul Cullinan

Hille Suojalehto, Finnish Institute of Occupational Health Hille Suojalehto

If you would like to become a known author and have your picture displayed along with your papers then please get in touch from the contact page. Known authors can choose to receive emails when their papers receive comments.

Abstract

Specific inhalation challenge is considered a reference standard in the diagnosis of occupational asthma. An updated handbook of challenge techniques for a large number of sensitising agents from 11 European centres is now available. http://bit.ly/2XVpW1P
When undertaken carefully, and in experienced hands, specific inhalation challenge (SIC) testing is widely considered to be the reference standard in the diagnosis of occupational asthma. In 2013 the European Respiratory Society commissioned a pan-European task force to produce standards for the conduct and interpretation of SIC with the aim of sharing expertise among those centres who offer the service and with centres who wish to develop a new service. The findings and recommendations of the taskforce were published in the European Respiratory Journal [1].

Alongside the main report, we produced a handbook of challenge techniques for a large number of different sensitising agents, including both those of high and low molecular mass. We committed ourselves to provide an update within 5 years; this has been completed, as planned, and is presented as a supplementary file to this editorial. The techniques are those used in 11 specialist centres and are listed by agent category with contact information for each centre should practitioners require more detailed information; the occupational asthma community in Europe prides itself on being collaborative, and collectively is happy to share its experience and expertise.

Controlled, experimental SIC was first developed – formally, as a diagnostic tool for occupational asthma – around 50 years ago, in a single centre. Its practice has flourished and spread since but it is fair to say that access remains patchy, with some European countries, and many regions within them, having no provision at all. This disadvantages patients who require the highest standard of diagnostic accuracy, employers who need to know which of the agents in their workplaces is giving rise to disease in their workers, and regulators charged with controlling what is essentially a preventable disease. Moreover, it hampers the identification of novel sensitisers and the exploration of the mechanisms behind their sensitising properties; this is, perhaps, especially important in the study of chemical sensitisers and particularly so since, rightly or wrongly, they are now considered Substances of Very High Concern under REACH. For these reasons we encourage respiratory physicians and the commissioners of healthcare to familiarise themselves with the relevant guidelines and to consider the equitable provision of SIC across Europe wherever the resources to perform SIC safely and with high quality can be ensured.

Plain text: Specific inhalation challenge is considered a reference standard in the diagnosis of occupational asthma. An updated handbook of challenge techniques for a large number of sensitising agents from 11 European centres is now available. http://bit.ly/2XVpW1P When undertaken carefully, and in experienced hands, specific inhalation challenge (SIC) testing is widely considered to be the reference standard in the diagnosis of occupational asthma. In 2013 the European Respiratory Society commissioned a pan-European task force to produce standards for the conduct and interpretation of SIC with the aim of sharing expertise among those centres who offer the service and with centres who wish to develop a new service. The findings and recommendations of the taskforce were published in the European Respiratory Journal [1]. Alongside the main report, we produced a handbook of challenge techniques for a large number of different sensitising agents, including both those of high and low molecular mass. We committed ourselves to provide an update within 5 years; this has been completed, as planned, and is presented as a supplementary file to this editorial. The techniques are those used in 11 specialist centres and are listed by agent category with contact information for each centre should practitioners require more detailed information; the occupational asthma community in Europe prides itself on being collaborative, and collectively is happy to share its experience and expertise. Controlled, experimental SIC was first developed - formally, as a diagnostic tool for occupational asthma - around 50 years ago, in a single centre. Its practice has flourished and spread since but it is fair to say that access remains patchy, with some European countries, and many regions within them, having no provision at all. This disadvantages patients who require the highest standard of diagnostic accuracy, employers who need to know which of the agents in their workplaces is giving rise to disease in their workers, and regulators charged with controlling what is essentially a preventable disease. Moreover, it hampers the identification of novel sensitisers and the exploration of the mechanisms behind their sensitising properties; this is, perhaps, especially important in the study of chemical sensitisers and particularly so since, rightly or wrongly, they are now considered Substances of Very High Concern under REACH. For these reasons we encourage respiratory physicians and the commissioners of healthcare to familiarise themselves with the relevant guidelines and to consider the equitable provision of SIC across Europe wherever the resources to perform SIC safely and with high quality can be ensured.

Full Text

Full text of this reference not available

Please Log In or Register to add the full text to this reference

Associated Questions

There are no associations for this paper.

Please Log In or Register to put forward this reference as evidence to a question.

Comments

This document shows how to carry out specific inhalation tests for occupational asthma
How to carry out specific inhalation tests for occupational asthma
9/17/2019

eyoYIlHO
10/16/2019

vRWmtGsiuA
10/16/2019

Please sign in or register to add your thoughts.


Oasys and occupational asthma smoke logo