Abstract

In general, it is important to make an accurate diagnosis of occupational asthma (OA). The disease not only has a significant impact on the health of affected workers, but also has significant socioeconomic impacts on workers,their employers and society at large. Failure to diagnose OA can lead to continued exposure to the pathogen and exacerbation of the disease. Conversely, the absence of a diagnosis of OA can lead to inappropriate exclusion from exposure, with unnecessary economic and social consequences. The most accurate assessment is a specific inhalation challenge at an experienced center, but this is a scarce resource and often relies on other tests. Based on available evidence, a practical diagnostic algorithm is proposed that can be adapted to the suspected pathogen,diagnostic objectives, and available resources. For better or worse, many of the techniques and their interpretation are only available in specialized centers, and when in doubt, referral to such centers is probably recommended.The establishment or development of such specialized centers should greatly improve the diagnostic assessment of work-related asthma.