Tarlo S M, Broder I
Toronto General Hospital, Canada.
Chest. 1991 Aug;100(2):329-35. doi: 10.1378/chest.100.2.329.
Among 154 referrals to a university hospital clinic for assessment of possible occupational asthma, the feasibility and results of different investigations were assessed using a consistent approach to all patients. A positive skin test to a workplace allergen (14 percent of all subjects), positive peak flow workplace changes (12 percent), improvement in methacholine response on holiday (9 percent), and/or positive specific challenge testing (14 percent) supported the diagnosis of occupational asthma in 61 subjects (39 percent of the total referrals). Fifty-one of these were related to a workplace sensitizer and ten to a presumed irritant. Occupational asthma was excluded in 48 subjects (31 percent) who had normal methacholine responsiveness within 24 hours of work (22 percent of the 154 subjects), peak flow readings no worse at work than on holidays (14 percent of the total referrals) and/or negative specific challenge testing (10 percent of the total referrals). Insufficient information could be obtained for a diagnosis in the remaining 45 subjects (28 percent). No single investigation was considered diagnostic in this study, as each could be positive or negative for other reasons.
在转诊至一家大学医院诊所评估可能的职业性哮喘的154例患者中，采用一致的方法对所有患者评估了不同检查的可行性和结果。对工作场所过敏原皮肤试验呈阳性（占所有受试者的14%）、工作场所峰值流量变化呈阳性（12%）、假期期间乙酰甲胆碱反应改善（9%）和/或特异性激发试验呈阳性（14%），支持61例受试者（占转诊总数的39%）诊断为职业性哮喘。其中51例与工作场所致敏原有关，10例与推测的刺激物有关。48例受试者（占154例受试者的31%）被排除职业性哮喘，这些受试者在工作24小时内乙酰甲胆碱反应正常（占154例受试者的22%）、工作时峰值流量读数不比假期时差（占转诊总数的14%）和/或特异性激发试验阴性（占转诊总数的10%）。其余45例受试者（28%）无法获得足够信息进行诊断。本研究中没有单一检查被认为具有诊断性，因为每项检查都可能因其他原因呈阳性或阴性。
