How to Diagnose Occupational asthma

To make a diagnosis Occupational asthma, please note a history of atopy, exposure assessment, immunology (molecular and cellular), photograph and physiology as hipereaktivitas lung bronchus, lung function series, the specific inhalation test is the gold standard.

The diagnosis of occupational asthma in principle is to connect the clinical symptoms of asthma in the working environment is therefore a need for a good history and appropriate investigations. Thorough history of what happened in the work environment is essential, such as: when to start work somewhere this time, what the job before at work today, what is done every day, the process of what happens in the workplace, the materials used in the production process and the data material. And that is not less important is the field review by the examiner (doctor) to better understand the field situation.



In addition to the history of the workplace, which should also know is about the clinical happening. When the first occurrence of complaints, since these began to enter the place or what is known as the latent period. Latent period can be several weeks to several years, usually 1-2 year. Clinical tightness, coughing, wheezing may occur during work, after work (evening and night) or both. When the frequency of attacks more often / deteriorated during weekdays than weekends or holidays, it can be suspected asthma that arise related to the workplace.

Investigations Spirometry (FEV1 checks) before and after the shift. Said to be positive if FEV1 decreased by more than 5% between before and after work; on the normal variable is less than 3%. This examination by many experts doubt the sensitivity because one study only 20% of patients with asthma due to colophony which fell during the workshift FEV1nya; while the decline in FEV1 is also found in 10% of a group of people who are not asthmatic (control).

Another way is to measure FEV1 and FVC in workers (suspected occupational asthma) are excluded from the work environment and then measured again at work again. If the results show improvement over leaving the workplace and supported by improvements to the complaints, it can be inferred the existence of the relationship of clinical and workplace grievances.

PEFR: Examination of serial PEFR (peak expiratory flow rate) during weekdays and a few days off at home, an examination of occupational asthma is best. It said the positive response when the curve measurements during the holidays at home is better than during weekdays.

Provocation test

There are two kinds of checks:

1. Namely non-specific bronchial provocation using histamine or methacholine. This examination is only proving the existence of bronchial hiperreaktif.
2. Specific bronchial provocation with allergens is the suspected cause. This examination can be carried out when the best way of proving that the allergen is the cause of the workplace. The difficulty lies in determining the cause and reproduction when allergens are known.

Skin tests and serological tests
This examination can be done if the causative agent of its large molecular weight material as it will stimulate the immunological reactions (IgE).

Management of Occupational asthma

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