Occupational Asthma Reference

Hannu T, Lindström I, Palmroos P, Kuuliala O, Sauni R, Prediction of obeche wood-induced asthma by specific skin prick testing, Occup Med, 2013;63:429-431,
(Plain text: Hannu T, Lindstrom I, Palmroos P, Kuuliala O, Sauni R, Prediction of obeche wood-induced asthma by specific skin prick testing, Occup Med)

Keywords: Finland, obeche, skin prick test, dignosis, SIC, challenge, sensitivity, specificity, key

Known Authors

Timo Hannu, Finnish Institute of Occupational Health Timo Hannu

Irmeli Lindstrom, Finnish Institute of Occupational Health Irmeli Lindstrom

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Abstract

Background
It has previously been shown that a positive skin prick test (SPT) result is a good predictor of a positive specific inhalation challenge (SIC) in patients with occupational asthma (OA) related to wheat or rye flours. This association has not been previously studied in OA attributable to obeche wood.

Aims
To describe a clinical series of patients with OA induced by obeche wood. To investigate if the SPT result can be used as a predictor for the outcome of SIC tests.

Methods
OA was diagnosed according to patient history, lung function examinations and SIC tests, as well as the determination of obeche SPTs. We analysed sensitivity, specificity and positive (PPV) and negative predictive values (NPV) at different wheal sizes of the SPTs and drew receiver-operating characteristic plots using the SIC test result as the gold standard.

Results
Obeche wood SIC tests were performed on 34 symptomatic workers. Of these, 27 workers had a positive test result and were diagnosed as having OA. The minimal cut-off value with a PPV of 100% was an SPT wheal of 3.5 mm from obeche wood. This means that all workers with a wheal size of =3.5 mm from obeche wood had a positive SIC.

Conclusions
Positive SPT results in symptomatic workers were good predictors of a positive SIC. SIC with obeche wood may be unnecessary in strongly sensitized workers.

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Associated Questions

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What are the sensitivity and the specificity of specific IgE testing in the diagnosis of validated cases of occupational asthma?
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Comments

Skin prick tests to Obeche (probably from an Abello, Copenhagen extract although this is not completely clear) showed high sensitivity (74%) with a >=3.5 mm wheal. All (34) workers had an immediate reaction on challenge testing. 7 had negative challenges; 1/7 had a positive skin prick test.
8/31/2013

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