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Current diagnostic methods for diisocyanate induced occupational asthma
Author(s) -
Bernstein David I.,
Jolly Athena
Publication year - 1999
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199910)36:4<459::aid-ajim7>3.0.co;2-w
Subject(s) - occupational asthma , medicine , asthma , occupational medicine , intensive care medicine , toluene diisocyanate , diagnostic test , allergy , occupational exposure , immunology , pediatrics , environmental health , materials science , composite material , polyurethane
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. Am. J. Ind. Med. 36:459–468, 1999. © 1999 Wiley‐Liss, Inc.