D I Bernstein1, A Jolly. 1. Division of Immunology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
Abstract
BACKGROUND: Diisocyanates are among the most frequent causes of occupational asthma in industrialized countries. Early diagnosis of diisocyanate asthma followed by prompt termination of chemical exposure can prevent chronic morbidity due to persistent asthma. The accurate diagnosis of diisocyanate asthma requires a systematic approach that combines information obtained from the occupational history, immunologic tests and physiologic studies. METHODS: The advantages, limitations and validity of various methods and diagnostic guidelines utilized in the evaluation of diisocyanate asthma are reviewed. RESULTS: Recommended methods for evaluation of diisocyanates asthma are similar to approaches for other causative agents. Serologic assays of specific IgE are specific but insensitive diagnostic markers of diisocyanate asthma. If possible, workers should be evaluated, while at work, in order to demonstrate work-related changes in lung function associated with diisocyanate exposures. Specific bronchoprovocation challenge testing with diisocyanates, is reserved for situations where the diagnosis cannot be confirmed at work. Such tests can be performed safely but should be conducted exclusively at specialized centers by experienced personnel. CONCLUSIONS: Published diagnostic guidelines for occupational asthma are directly applicable to the evaluation of diisocyanate asthma. Copyright 1999 Wiley-Liss, Inc.
BACKGROUND:Diisocyanates are among the most frequent causes of occupational asthma in industrialized countries. Early diagnosis of diisocyanateasthma followed by prompt termination of chemical exposure can prevent chronic morbidity due to persistent asthma. The accurate diagnosis of diisocyanateasthma requires a systematic approach that combines information obtained from the occupational history, immunologic tests and physiologic studies. METHODS: The advantages, limitations and validity of various methods and diagnostic guidelines utilized in the evaluation of diisocyanateasthma are reviewed. RESULTS: Recommended methods for evaluation of diisocyanatesasthma are similar to approaches for other causative agents. Serologic assays of specific IgE are specific but insensitive diagnostic markers of diisocyanateasthma. If possible, workers should be evaluated, while at work, in order to demonstrate work-related changes in lung function associated with diisocyanate exposures. Specific bronchoprovocation challenge testing with diisocyanates, is reserved for situations where the diagnosis cannot be confirmed at work. Such tests can be performed safely but should be conducted exclusively at specialized centers by experienced personnel. CONCLUSIONS: Published diagnostic guidelines for occupational asthma are directly applicable to the evaluation of diisocyanateasthma. Copyright 1999 Wiley-Liss, Inc.
Authors: Laura D Cassidy; Brent Doney; Mei Lin Wang; Laura Kurth; Patrick R Conner; James J Collins; Michael Carson; Don Molenaar; Carrie A Redlich; Eileen Storey Journal: J Occup Environ Med Date: 2017-12 Impact factor: 2.162
Authors: Bjarke Mølgaard; Anna-Kaisa Viitanen; Anneli Kangas; Marika Huhtiniemi; Søren Thor Larsen; Esa Vanhala; Tareq Hussein; Brandon E Boor; Kaarle Hämeri; Antti Joonas Koivisto Journal: Int J Environ Res Public Health Date: 2015-04-02 Impact factor: 3.390