Safety of specific challenges with occupational agents

Specific inhalation testing with occupational agents is generally safe. Since these tests were first developed protocols have accelerated increasing dosage to fit a series of challenges into 4-5 days. 335 consecutive positive challenges from a unit performing SIC as the first confirmatory investigation of occupational asthma reported moderate reactions needing tratment with inhaled bronchodilators in 12%, 3% had severe reactions requuring oral steroids. The highest group at risk were those exposed to short exposures to low molecular weight agents. It is important to start with very short exposures (e.g. 1 breath, then 10 breaths) as in original protocols

References

	Vandenplas O, D'Alpaos V, Evrard G, Jamart J, Incidence of Severe Asthmatic Reactions After Challenge Exposure to Occupational Agents, Chest, 2013;143:1261-1268,

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