RT Journal Article
SR Electronic
T1 Do laboratory challenge tests for occupational asthma represent what happens in the workplace?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1800059
DO 10.1183/13993003.00059-2018
A1 P Sherwood Burge
A1 Vicky C Moore
A1 Alastair S Robertson
A1 Gareth I Walters
YR 2018
UL http://erj.ersjournals.com/content/early/2018/05/03/13993003.00059-2018.abstract
AB Introduction Specific inhalation challenge (SIC) is the diagnostic reference standard for occupational asthma, however the significance of a positive test is doubtful unless it can be reproduced by usual work exposures. We have compared the timing and responses during SIC in hospital to Oasys analysis of serial PEF during usual work exposures.Methods All workers with a positive SIC to occupational agents between 2006 and 2015 were asked to measure PEF 2-hourly from waking to sleeping for 4 weeks during usual occupational exposures. Responses were compared between the laboratory challenge and the real-world exposures at work.Results All 53 workers with positive SIC were included. 49/53 had records suitable for Oasys analysis, 14 requiring >1 attempt, all confirmed occupational work-related changes in PEF. There was a significant correlation between immediate SIC reactors and deterioration within the first 2 hours of starting work with early recovery, and between late SIC reactors and a delayed start to workplace deterioration and delayed recovery. Dual SIC reactions had features of immediate or late SIC reactions at work rather than dual reactions.Conclusion The concordance of timings of reactions during SIC and at work provide further validation for the clinical significance of each test.Positive specific challenge tests with occupational agents in the laboratory and real-life work exposures monitored with PEF show similar reactionsFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Burge has nothing to disclose.Conflict of interest: Vicky Moore has nothing to disclose.Conflict of interest: Dr. Robertson has nothing to disclose.Conflict of interest: Gareth Walters has nothing to disclose.