The DOI matches its Crossref record.
Is the Clinical History a Satisfactory Means of Diagnosing Occupational Asthma?
Abstract
Abstract In some countries a diagnosis of occupational asthma for medicolegal purposes is made when a questionnaire is suggestive and the individual is exposed to a product known to be a sensitizer. The value of an open questionnaire administered by physicians with experience in occupational asthma is unknown, however. We prospectively assessed all subjects (162) referred to our clinic because their physicians thought their asthma might be work related. The medical questionnaire included questions about the nature of the symptoms (dyspnea, wheezing, cough, and chest tightness) and the timing (worse at work or after a shift at work or improved during weekends or holidays). An initial clinical assessment was set by the physician on a scale that ranged from highly probable to probable, uncertain, unlikely, or absent. Subjects then underwent objective assessment with specific inhalation challenges (n = 72), serial monitoring of peak expiratory flow rates for periods at work and away from work (n = 29), or both (n = 61), to confirm or rule out the diagnosis of occupational asthma. A total of 75 subjects (46%) were shown to have occupational asthma. Symptoms alone (type and timing) did not provide a satisfactory differentiation between those subjects with and those without occupational asthma. For example, 66 of 75 (88%) subjects with occupational asthma said that their symptoms improved during holidays, but 66 of 87 (76%) subjects without occupational asthma experienced a similar improvement. Based on the initial clinical assessment, it was found that the predictive value of a history that suggested that occupational asthma was highly probable or probable was 63% (65 of 104), whereas the predictive value of a history indicating that occupational asthma was unlikely or absent was 83% (19 of 23). These figures suggest that an open medical questionnaire is not a satisfactory means of diagnosing occupational asthma. Objective means should also be used.
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Citations
Cited by
Chan-Yeung, M. (1986) · Clinical Reviews in Allergy · doi:10.1007/bf02993160 · Cited by 424
Tarlo, S. M., & Lemiere, C. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1301758 · Cited by 337
Evidence based guidelines for the prevention, identification, and management of occupational asthma
Nicholson, P. J., Cullinan, P., Newman Taylor, A. J., Burge, P. S., & Boyle, C. (2005) · Occupational and Environmental Medicine · doi:10.1136/oem.2004.016287 · Cited by 320
Mapp, C. E., Boschetto, P., Maestrelli, P., & Fabbri, L. M. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200311-1575so · Cited by 282
Del Giacco, S. R., Bakirtas, A., Bel, E., Custovic, A., Diamant, Z., Hamelmann, E., Heffler, E., Kalayci, Ö., Saglani, S., Sergejeva, S., et al. (2017) · Allergy · doi:10.1111/all.13072 · Cited by 130
“Here, a detailed occupational and medical history is fundamental (159, 160), while a clinical history only shows a low specificity in the diagnosis of OA (161).”
Background
Metadata
- Authors
- Malo, J.-L., Ghezzo, H., L'archevêque, J., Lagier, F., Perrin, B., & cartier, A.
- Venue
- American Review of Respiratory Disease
- Publisher
- Oxford University Press (OUP)
- Published
- 1991-03
- Volume
- 143
- Issue
- 3
- Pages
- 528-532
- ISSN
- 0003-0805 (ISSN-L)
- OpenAlex
- W2156235273
- Cited by
- 258
- References
- 0
- FWCI
- 9.77
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Is the Clinical History a Satisfactory Means of Diagnosing Occupational Asthma? https://app.cochat.ai/papers/10.1164/ajrccm/143.3.528
- The paper
- Malo, J.-L., Ghezzo, H., L'archevêque, J., Lagier, F., Perrin, B., & cartier, A. (1991). Is the Clinical History a Satisfactory Means of Diagnosing Occupational Asthma? American Review of Respiratory Disease. https://doi.org/10.1164/ajrccm/143.3.528
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
