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occupational asthma examination, diagnosis of occupational asthma

occupational asthma examination, diagnosis of occupational asthma

Common examinations for occupational asthma

Inspection Name Inspection Site Inspection Department Inspection Function
Pulmonary function , respiratory health department, pulmonary function examination...
Patients with small airway function, lung, breathing, and cardiothoracic do not have clinical...
Bronchial provocation test lung - bronchial provocation test...
Specific IgE testing uses common allergens and specific allergen complexes as a skin test to understand whether the patient has atopic physique and help determine whether the patient is sensitive to specific occupational allergens. The radioallergen adsorption test (RAST) or ELISA method can be used to detect IgE antibodies against occupational allergens in the serum of patients. These two methods have higher sensitivity but poor specificity.

1. Pulmonary function Pulmonary function is used to observe the indicators of occupational asthma including PEF, FEV1 (forced expiratory volume in one second) and so on. Continuous observation of PEF has certain significance for the diagnosis of occupational asthma. It requires patients to measure it every 2 hours regardless of work or rest, for several weeks, which can help determine whether airway obstruction caused by asthma is related to work. This method is highly sensitive but not specific enough.

2. Non-specific bronchial provocation test Continuous non-specific bronchial provocation test with formylcholine or histamine can confirm whether the patient has airway hyperresponsiveness and help determine the relationship between airway responsiveness changes and the work environment. When the patient normally goes to work for more than 2 weeks, if the reaction is negative, even if there are related symptoms, the diagnosis of occupational asthma can be ruled out. If the patient is tested negative after a period of absence from work, occupational asthma cannot be ruled out accordingly.

3. Specific bronchial provocation test It is currently believed that the specific bronchial provocation test is a gold indicator for the diagnosis of occupational asthma. This test has a certain degree of danger and requires professionals to operate and prepare rescue measures. The entire test takes several days to complete. On the first day, bronchodilators are stopped and the basic lung function is measured. The difference in FEV1 should not exceed 10%; on the second day, after inhaling a soluble aerosol, the patient’s lung function is measured as a control; on the third day , Let the patient be exposed to the allergen, the contact time depends on the nature and dose of the allergen, ranging from 1 to 10 minutes. For high molecular weight allergens, FEV1 is measured once every 10 minutes, and the allergen dose is increased once every 20 minutes. The test can be completed on the same day. For low-molecular-weight allergens, since it induces mostly late-phase allergic reactions, it takes several days to slowly increase the dose. FEV1 was measured every 10 minutes within 1 hour, then every 30 minutes for 2 hours, and then every 1 hour for 8 hours. A 20% decrease in FEV1 is a positive reaction.


care of occupational asthma


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