What are the sensitivity and the specificity of a normal measurement of non-specific reactivity while at work in the diagnosis of occupational asthma?

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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.

Evidence

Anees W, Huggins V, Pavord ID, Robertson AS, Burge PS , Occupational Asthma Due To Low Molecular Weight Agents : Eosinophilic And Non-Eosinophilic Variants , Thorax , 2002 ; 57 : 231-236

Baur X, Huber H, Degens PO, Allmers H, Ammon J , Relation Between Occupational Asthma Case History, Bronchial Methachlorine Challenge, And Specific Challenge Test In Patients With Suspected Occupational Asthma , Am J Ind Med , 1998 ; 33 : 114-122

Brisman J, Lillienberg L, Belin L et al , Sensitisation To Occupational Allergens In Bakers' Asthma And Rhinitis: A Case-Referent Study , Int Arch Occup Environ Health , 2003 ; 76 : 167-170

Burge PS , Occupational asthma in electronics workers caused by colophony fumes: Follow-up of affected workers , Thorax , 1982 ; 37 : 348-353

Cartier A, Grammer L, Malo JL et al , Specific Serum Antibodies Against Isocyanates: Association With Occupational Asthma , J Allergy Clin Immunol , 1989 ; 84 : 507-514

Hargreave FE, Ramsdale EH, Pugsley SO , Occupational Asthma Without Bronchial Hyper-responsiveness , Am Rev Respir Dis , 1984 ; 130 : 513-515

Koskela H, Taivainen A, Tukiainen H et al , Inhalation challenge with bovine dander allergens: who needs it? , Chest , 2003 ; 124 : 383-391

Lemiere C, Cartier A, Malo JL et al , Persistent specific bronchial reactivity to occupational agents in workers with normal nonspecific bronchial reactivity , Am J Respir Crit Care Med , 2000 ; 162 : 976-980

Lin FJ, Chen H, ChanYeung M , New Method For An Occupational Dust Challenge Test , Occup Environ Med , 1995 ; 52 : 54-56

Malo JL, Ghezzo H, L'Archeveque J et al , Is The Clinical History A Satisfactory Means Of Diagnosing Occupational Asthma? , Am Rev Respir Dis , 1991 ; 143 : 528-532

Merget R, Dierkes A, Rueckmann A, Bergmann EM, SchultzeWerninghaus G , Absence Of Relationship Between Degree Of Nonspecific And Specific Bronchial Responsiveness In Occupational Asthma Due To Platinum Salts , Eur Respir J , 1996 ; 9 : 211-216

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

Moscato G, Dellabianca A, Vinci G et al , Toluene Di-isocyanate-Induced Asthma : Clinical Findings And Bronchial Responsiveness Studies In 113 Exposed Subjects With Work-Related Respiratory Symptoms , J Occup Med , 1991 ; 33 : 720-725

Perrin B, Lagier F, L'Archeveque J, Cartier A, Boulet LP, Cote J, Malo JL , Occupational Asthma: Validity Of Monitoring Of Peak Expiratory Flow Rates And Non-Allergic Bronchial Responsiveness As Compared To Specific Inhalation Challenge , Eur Respir J , 1992 ; 5 : 40-8

Ricciardi L, Fedele R, Saitta S et al , Occupational asthma due to exposure to iroko wood dust , Ann Allergy Asthma Immunol , 2003 ; 91 : 393-397

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

Vandenplas O, BinardVanCangh F, Brumagne A et al , Occupational Asthma In Symptomatic Workers Exposed To Natural Rubber Latex: Evaluation Of Diagnostic Procedures , J Allergy Clin Immunol , 2001 ; 107 : 542-547

Vandenplas O, Delwiche JP, Evrard G et al , Prevalence of occupational asthma due to latex among hospital personnel , Am J Respir Crit Care Med , 1995 ; 151 : 54-60