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Cited by 128Occupational exposure and asthmaAsthma and respiratory diseasesOccupational Health and Safety in Workplaces

A systematic review of the diagnosis of occupational asthma

Beach, Jeremy, Russell, Kelly, Blitz, Sandra, Hooton, Nicola, Spooner, Carol, Lemiere, Catherine, Tarlo, Susan M., Rowe, Brian H.·2007·Chest
DOI 10.1378/chest.06-0492
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Abstract

Background This study systematically reviews literature regarding the diagnosis of occupational asthma (OA) and compares specific inhalation challenge (SIC) testing with alternative tests.Methods Electronic databases and trials registries were searched; additional references were identified from bibliographic searches of included studies, hand searches of conferences, and author contacts. Various study designs (clinical trials, cohorts, cross-sectional, or case series) were included involving workers with suspected OA. All diagnostic tests were compared to a "reference standard," and two researchers independently extracted 2 x 2 data. Pooled sensitivities and specificities (95% confidence intervals [CIs]) were derived.Results Seventy-seven studies were included. For high molecular weight (HMW) agents, the nonspecific bronchial provocation (NSBP) test, skin-prick test (SPT), and serum-specific IgE had sensitivities > 73% when compared to SIC. Specificity was highest for specific IgE vs SIC (79.0%; 95% CI, 50.5 to 93.3%). The highest sensitivity among low molecular weight asthmagens occurred between combined NSBP and SPT vs SIC (100%; 95% CI, 74.1 to 100%). When compared to SIC, specific IgE and SPT had similar specificities (88.9%; 95% CI, 84.7 to 92.1%; and 86.2%; 95% CI, 77.4 to 91.9%, respectively). For HMW agents, high specificity was demonstrated for positive NSBP tests and SPTs alone (82.5%; 95% CI, 54.0 to 95.0%) or when combined with specific IgE (74.3%; 95% CI, 45.0 to 91.0%) vs SIC. Sensitivity was somewhat lower (60.6% and 65.2%, respectively).Conclusions In appropriate clinical situations when SIC is not available, the combination of a NSBP test with a specific SPT or specific IgE may be an appropriate alternative to SIC in diagnosing OA. While positive results of single NSBP test, specific SPT, or serum-specific IgE testing would increase the likelihood of OA, a negative result could not exclude OA.

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Crossref · 10.1378/chest.06-0492

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  • A diagnosis of WRA requires the objective diagnosis of asthma with symptoms temporally related to the individual's place of employment.

    “A diagnosis of WRA requires the objective diagnosis of asthma with symptoms temporally related to the individual's place of employment (141).”

    From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [141]

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Authors
Beach, J., Russell, K., Blitz, S., Hooton, N., Spooner, C., Lemiere, C., Tarlo, S. M., & Rowe, B. H.
Affiliations
  • University of Alberta (CA)
  • University of Toronto (CA)
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2007-02
Volume
131
Issue
2
Pages
569-578
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.06-0492
OpenAlex
W2037203787
Cited by
128
References
12
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 2 · 2020: 11 · 2019: 8 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 10 · 2014: 10 · 2013: 10 · 2012: 8
FWCI
1.32
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
Keywords
occupational asthma, diagnosis, specific inhalation challenge, skin prick test, serum specific IgE, diagnostic accuracy
MeSH terms
Asthma, Humans, Immunologic Tests, Occupational Diseases, Respiratory Function Tests

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