Reference

Merget R, SchultzeWerninghams G, Bode F et al, Quantitative Skin Prick And Bronchial Provocation Tests With Platinum Salt, Br J Ind Med, 1991;48:830-837,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Diagnosis of occupational asthma is based upon a history of work-related symptoms and positive skin prick test (SPT) with platinum salts. Bronchial provocation tests (BPT) have not been performed in epidemiological studies because the SPT is believed to be highly specific and sensitive. Study assesses use of SPT and BPT with methacholine and platinum salt. 27 of 35 workers, who were referred to our clinic with work-related symptoms and 9 control subjects with bronchial hyper-reactivity, underwent a SPT and BPT with methacholine and platinum salt. 22 workers had a positive BPT, 4 of which had a negative SPT. It is concluded that BPT with platinum salts should be performed on workers with work-related symptoms but negative SPT with platinum salts.

The following comments are from the editors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Loss of SPT positivity with removal from exposure observed

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

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A large number of concordant studies from different centres using different methodologies demonstrated that increased non-specific reactivity is often found in workers with occupational asthma. There are however many reports of normal methacholine or histamine reactivity within 24 hours of exposure in workers with confirmed occupational asthma.

Skin prick tests are highly sensitive but less specific for occupational asthma caused by complex platinum salts.

Non Bohrf Information

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