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Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement.

Vandenplas, Olivier and Suojalehto, Hille and Aasen, Tor B and Baur, Xaver and Burge, P Sherwood and de Blay, Frederic and Fishwick, David and Hoyle, Jennifer and Maestrelli, Piero and Muñoz, Xavier and Moscato, Gianna and Sastre, Joaquin and Sigsgaard, Torben and Suuronen, Katri and Walusiak-Skorupa, Jolanta and Cullinan, Paul (2014) Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement. The European respiratory journal, 43 (6). pp. 1573-87. ISSN 1399-3003. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Official URL: http://erj.ersjournals.com/content/43/6/1573.full....

Abstract

This consensus statement provides practical recommendations for specific inhalation challenge (SIC) in the diagnosis of occupational asthma. They are derived from a systematic literature search, a census of active European centres, a Delphi conference and expert consensus. This article details each step of a SIC, including safety requirements, techniques for delivering agents, and methods for assessing and interpreting bronchial responses. The limitations of the procedure are also discussed. Testing should only be carried out in hospitals where physicians and healthcare professionals have appropriate expertise. Tests should always include a control challenge, a gradual increase of exposure to the suspected agent, and close monitoring of the patient during the challenge and for at least 6 h afterwards. In expert centres, excessive reactions provoked by SIC are rare. A positive response is defined by a fall in forced expiratory volume in 1 s ≥ 15% from baseline. Equivocal reactions can sometimes be clarified by finding changes in nonspecific bronchial responsiveness, sputum eosinophils or exhaled nitric oxide. The sensitivity and specificity of SIC are high but not easily quantified, as the method is usually used as the reference standard for the diagnosis of occupational asthma.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: WF Respiratory system. Respiratory medicine
Divisions: Planned IP Care > Respiratory Medicine
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 12 Sep 2014 14:21
Last Modified: 12 Sep 2014 14:21
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/753

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