Reference

Tarlo SM, Broder I, Outcome of assessment for occupational asthma, Chest, 1991;100:329-335,

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.

Study assessed the feasibility and results of different investigations using a consistent approach to 154 patients referred to clinic for possible occupational asthma. A positive skin test to a workplace allergen (14%), positive peak flow workplace changes (12%), improvement in methacholine response on holiday (9%), and/or positive specific challenge testing (14%) supported the diagnosis of occupational asthma in 61 subjects (39% of total referrals). 51 of these were related to a workplace sensitizer and 10 to a presumed irritant occupational asthma was excluded in 48 subjects (31%) who had normal methacholine responsiveness within 24 hours of work (22% of 54 subjects), peak flow readings no worse at work than on holidays (14% of total referrals) and/or negative specific challenge testing (10% of total referrals). Insufficient information could be obtained for a diagnosis in the remaining 45 subjects (28%). No single investigation was considered diagnostic in this study.

BOHRF Associated Evidence Statements

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

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2++

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.

Changes in non-specific reactivity at and away from work alone have only moderate sensitivity and specificity for diagnosis.

Paired measurements of non-specific reactivity may be achieved in the workplace.

Non Bohrf Information

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