Table E-3Description of diagnostic tests (Diagnosis review)

Author, YearHighest Reference StandardComparison Tests
TestPositive ResponseMethodologyTestPositive ResponseMethodology
Alvarez, 2001SIC: oilseed rape flour[greater, double equals]20% decline in FEV1 Referenced (Chatham et al., 1982)Eosinophils: sputumNot reportedDescribed in text
Single NSBPT: methacholineNot reportedReferenced (Chatham et al., 1982)
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mmReferenced (Dreborg, 1989)
Serum specific IgE>0.35 KU/LCAP
Alvarez, 1996SIC: cereals (wheat, alpha amylase, soyabean, l.destructor)[greater, double equals]20% decline in FEV1 Described in textSingle NSBPT: methacholinePD20 FEV1 [less, double equals]250 cbuReferenced (Chatham et al., 1982)
Skin prick: atopyWheal diameter [greater, double equals]3 mm with no reaction to negative controlReferenced (Chatham et al., 1982)
Serum specific IgECAP score [greater, double equals]class 1CAP
Anees, 2004Other: clinical diagnosisSIC and/or serum specific IgE and/or serial NSBPTNot reportedSerial PFT (PEFR): monitored at least 3 times/day for at least 5 work (4–6 days) and rest (2–3 days) periodsOASYS-2 score >2.5Referenced (Burge et al., 1999)
Avery, 1969Other: clinical diagnosisNot reportedNot reportedOther: TDI-HSANot reportedDescribed in text
Balland, 1989SIC: suspected agent[greater, double equals]100% increase in specific airway resistanceNot reportedSingle NSBPT: methacholine[greater, double equals]2 fold increase in airway resistance between 0–1500 gamma of methacholineNot reported
Serum specific IgENot reportedRAST
Serum total IgENot reportedNot reported
Baur, 1998SIC: suspected agent[greater, double equals]40% decline in sGawReferenced (Jaeger et al., 1992; Marek et al., 1994; Schwaiblmair et al.1991)Clinical diagnosisCase history: reversible airway narrowing in the sense of SOB and wheezing causally related to exposure in the working environmentDescribed in text
Single NSBPT: methacholinePD40 sGaw <0.3 mgDescribed in text
Baur, 1979SIC: papainNot reportedNot reportedSkin prick: atopy and specificNot reportedReferenced (Aas and Belin, 1972)
Serum specific IgENot reportedRAST
Behr, 1990SIC: isocyanates[greater, double equals]100% increase in sRaw from baseline and absolute values [greater, double equals]2.0 kPa/sDescribed in textClinical diagnosisNot reportedNot reported
Single NSBPT: methacholine[greater, double equals]100% increase in sRaw from baseline and absolute values [greater, double equals]2.0 kPa/sDescribed in text
Bernstein, 2002SIC: isocyanates[greater, double equals]20% decline in FEV1 Referenced (Ryan et al., 1981; Stark et al., 1993)Other: di-isocyanate antigen stimulation of MCP-1Maximal antigen stimulation of MCP-1 [greater, double equals]mean + 2SD of control subjectsDescribed in text
Single NSBPT: methacholinePC20 FEV1 [less, double equals]8 mg/mlReferenced (Cockcroft et al., 1977)
Serum specific IgEOD at 405 [greater, double equals]0.1ELISA
Biot, 1980SIC: suspected agentNot reportedDescribed in textOther: basophils granules liberationNot reportedReferenced (Benveniste et al., 1976)
Single NSBPT: acetylcholineNot reportedNot reported
Serum total IgENot reportedNot reported
Block, 1983SIC: wheat and/or rye flour[greater, double equals]20% decline in FEV1 Referenced (Lam et al., 1979)Single NSBPT: methacholinePC20 FEV1: no cutoff reportedReferenced (Lam et al., 1979)
Skin prick: atopy and specificWheal diameter [greater, double equals]2 mmReferenced (Cockcroft et al., 1979)
Serum specific IgENot reportedRAST
Burge, 1985SIC: formaldehydeNot reportedDescribed in textSingle NSBPT: histaminePC20 FEV1 [less, double equals]32 mg/mlReferenced (deVries et al., 1964)
Burge, 1982bSIC: suspected agentNot reportedDescribed in textSingle NSBPT: histaminePD20 FEV1 <32 mg/mLReferenced (O'Brien et al., 1979)
Burge, 1980SIC: colophony, abietic acid, methyl ester, glycerol ester, amine hydrocholride[greater, double equals]15% decline in FEV1 Described in textSingle NSBPT: histaminePC20 FEV1 [less, double equals]16 mg/mlReferenced (deVries et al., 1964)
Burge, 1979aSIC: solder-flux fumes[greater, double equals]15% decline in FEV1 Referenced (Burge et al., 1978)Clinical diagnosisHistory and effects of subsequent exposure at workDescribed in text
Serial PFT (PEFR): monitored every hour while away for at least 2 wks at work and at least 2 wks awayComparison of recordings taken at work compared to those taken away from workDescribed in text
Burge, 1979bSIC: isocyanates[greater, double equals]15% decline in FEV1 Referenced (O'Brien et al., 1979)Clinical diagnosisFinal assessment based on subsequent course of asthma on re-exposure at workDescribed in text
Serial PFT (PEFR): monitored every hour or 2 hrs for at least 2 wks at work and 2 wks away[greater, double equals]25% of cases demonstrated specific daily pattern with a weekly patternReferenced (Burge et al., 1979)
Burge, 1978SIC: colophony>15% decline in FEV1 Not reportedEosinophils: bloodNot reported>400/mm3
Single PFT: FEV1, FVCNot reportedDescribed in text
Skin prick: atopyMean wheal diameter >2 mm with negative controlNot reported
Butcher, 1980SIC: TDINot reportedNot reportedSerum specific IgE2 definitions: ratio >2; test cpm >control mean + 3SDRAST
Serum total IgENot reportedPRIST
Carletti, 1997SIC: wheat flour>20% decline in FEV1 Described in textClinical diagnosisSymptoms of cough, expectoration,wheezing, dyspnea, difficulties breathing associated with exposure to wheat powder/flourDescribed in text
Single NSBPT: methacholinePD20 FEV1 <1 mgReferenced (Piaggaro et al., 1990)
Single PFT: FVC, FEV(25–75)Not reportedDescribed in text
Skin prick: atopy and specificMean wheal diameter [greater, double equals]5 mm for atopy and [greater, double equals]3 mm for specificDescribed in text
Cartier, 1989SIC: isocyanates[greater, double equals]3 consecutive values with [greater, double equals]20% decline in FEV1 and fluctuations not exceeding 10% on the controlReferenced (Pepys and Hutchcroft, 1975)Serial NSBPT: histamine or methacholine[greater, double equals]3.2 fold change in PC20 FEV1 before and after SICNot reported
Single NSBPT: histamine or methacholinePC20 FEV1 [less, double equals]16 mg/mlNot reported
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mm without dermographism and with wheal diameter [greater, double equals]3 mm to histamine controlDescribed in text
Serum specific IgEOD reading [greater, double equals]two times the OD of the mean of the negative controlsELISA
Serum specific IgGOD reading [greater, double equals]two times the OD of the mean of the negative controlsELISA
Cartier, 1987SIC: psyllium[greater, double equals]20% decline in FEV1 Referenced (Pepys and Hutchcroft, 1975)Single NSBPT: histaminePC20 FEV1 <8 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specificNot reportedDescribed in text
Serum specific IgENot reportedRAST
Cartier, 1986SIC: snowcrab extractNot reportedNot reportedSkin prick: specific1 Wheal diameter >2 mm larger than controlReferenced (Pepys, 1975)
Serum specific IgE1 2 cutoff values: >2; >4.5RAST
Eosinophils: blood2 >500 cells/ccNot reported
Serial NSBPT: histamine2 [greater, double equals]3.2 fold change in PC20 FEV1 upon return to workReferenced (Cockcroft et al., 1977)
Single NSBPT: histamine2 PC20 FEV1 [less, double equals]16 mg/mlReferenced (Cockcroft et al., 1977)
Choudat, 1999SIC: wheat flour[greater, double equals]20% decline in FEV1 Referenced (Cloutier et al., 1989)Single NSBPT: methacholinePD20 FEV1: no cutoffReferenced (Sterk et al., 1993)
Serum specific IgENot reportedCAP
Cirla, 1975SIC: TDINot reportedDescribed in textSingle NSBPT: acetylcholineNot reportedDescribed in text
Skin prick: atopy and specificNot reportedDescribed in text
Colas, 1985SIC: wood dust (exotic)[greater, double equals]100% increase in specific airway resistanceDescribed in textEosinophils: bloodNot reportedNot reported
Other: carbon dioxide diffusionNot reportedNot reported
Single NSBPT: carbachol[greater, double equals]100% increase in airways resistance (threshold dose)Not reported
Single PFT: FEV1, FVCPresence of “trouble ventilatoire obstructif” (airway obstruction)Not reported
Skin prick: atopy and specificNot reportedNot reported
Serum total IgENot reportedNot reported
Cortona, 1980Other: clinical diagnosisIncluded results from ECSC questionnaire and lung function testingDescribed in textSkin prick: atopy and SpecificNot reportedReferenced (Pepys, 1969)
Cote, 1993SIC: plicatic acid[greater, double equals]15% decline in FEV1 Referenced (Chan-Yeung et al., 1973)Serial PFT (PEFR): monitored 6 times/day for 3 wks at work and 2 wks away3 2 of 3 physicians agreed that PEF graphs showed work related change in 2 of 3 work wksReferenced (Burge et al., 1979)
Other: questionnaire3 Not reportedNot reported
Serial NSBPT: methacholine4 >2 fold decrease in PC20 FEV1 after 3 work wks compared to after 2 holiday wksReferenced (Lam et al., 1979)
Coutts, 1984SIC: cimetidine powderNot reportedNot reportedSingle NSBPT: histamineNot reportedNot reported
Skin prick: atopy and specificNot reportedNot reported
Curran, 1996Other: clinical diagnosisNot reportedNot reportedSerum specific IgE>0.88 net RAST % binding with serum total IgE equal to or less than 150 kU/LRAST
Serum total IgE<150 kU/LRIACT
Davison, 1983SIC: castor beansNot reportedReferenced (Davies et al., 1974)Skin prick: atopy Serum specific IgENot reportedNot reported
% binding >2 times the controlRAST
DeZotti, 1996aSIC: wood dust (exotic)[greater, double equals]15% decline in FEV1 Described in textEosinophils: bloodNot reportedNot reported
Single NSBPT: methacholinePD20 FEV1: no cutoffNot reported
Single PFT: FEV1, FVCNot reportedDescribed in text
Skin prick: atopyWheal diameter >3 mmDescribed in text
DeZotti, 1996bSIC: suspected agent[greater, double equals]15% decline in FEV1 Described in textEosinophils: bloodNot reportedDescribed in text
Single NSBPT: methacholinePD20 FEV1: no cutoffDescribed in text
Single PFT: FEV1 Not reportedDescribed in text
Skin prick: atopyWheal diameter [greater, double equals]3 mmNot reported
Serum specific IgENot reportedRAST
Dellabianca, 1996SIC: suspected agent[greater, double equals]15% decline in FEV1 Not reportedSingle NSBPT: methacholinePD20 FEV1 [less, double equals]1560 μDescribed in text
Dente, 1986SIC: TDINot reportedDescribed in textSingle NSBPT: methacholinePD15 FEV1 <1.0 mgNot reported
DiFranco, 1998SIC: suspected agentNot reportedNot reportedEosinophils: sputum>1%Described in text
Single NSBPT: methacholinePD20 FEV1 <1 mgDescribed in text
DiStefano, 1999Other: clinical diagnosisIncluded SIC and/or serial PFTDescribed in textSingle NSBPT: histamineNot reportedNo reference (Yan method)
Skin prick: atopyWheal diameter >3 mmNot reported
Duan, 1989SIC: TDI[greater, double equals]15% decline in FEV1 (lasted 15 minutes)Described in textClinical diagnosisAsthma symptoms at work, better or no symptoms away from workDescribed in text
Serial NSBPT: methacholine2 times (Chinese translation)Referenced (Cockcroft et al., 1977)
Serial PFT: PEFRNot reportedDescribed in text
Single PFT: FEV1 (including reversibility)FEV1 decrease 15–20%Described in text
Skin prick: specificNot reportedDescribed in text
Serum specific IgENot reportedELISA
Ferguson, 1996SIC: isocyanates[greater, double equals]15% decline in FEV1 (persistent)Described in textSingle NSBPT: histamineNot reportedReferenced (Cockcroft et al., 1977)
Single PFT: FEV1, FVC (including reversibility)Reversibility: [greater, double equals]15% increase in FEV1 Referenced (American Thoracic Society, 1987)
Serum specific IgENot reportedRAST
Gannon, 1996Other: clinical diagnosisIncluded SIC and/or bronchial hyperreactivity and/or serum specific IgE (RAST) and/or asymptomaticNot reportedSerial PFT (PEFR): monitored every 2 hrs for 2 wks at work and 2 wks awayOASYS-2 score [greater, double equals]2.51Referenced (Burge et al., 1979)
Girard, 2004SIC: suspected agentNot reportedReferenced (Cartier, 1997)Eosinophils: sputum3 cutoffs used: >1%, 2%, or 6.4%Referenced (Pizzichini et al., 1996)
Serial NSBPT: methacholine[greater, double equals]3.2 fold change in PC20 FEV1 between at work and awayReferenced (Juniper et al., 1994)
Serial PFT: PEFR2 definitions: OASYS-2 score [greater, double equals]2.51; clinical opinionReferenced (Burge et al., 1979)
Skin prick: atopyNot reportedNot reported
Graneek, 1987SIC: suspected agent>15% decline in FEV1 Referenced (Pepys and Hutchcroft, 1975)Single NSBPT: histaminePC20 FEV1 [less, double equals]16 mg/mlReferenced (Cockcroft et al., 1977)
Grosclaude, 1980SIC: suspected agent[greater, double equals]50% increase in airway resistanceDescribed in textSingle NSBPT: acetylcholineDose provoking augmentation of 50% of airway resistance [less, double equals]1000 μNot reported
Skin prick: atopy and specificNot reportedNot reported
Serum total IgENot reportedNot reported
Harries, 1980SIC: suspected agent[greater, double equals]15% decline in FEV1 Described in textEosinophils: blood Skin prick: atopyNot reportedNot reported
Wheal diameter >3 mm to at least 1 allergen with negative reaction to controlDescribed in text
Hinojosa, 1986SIC: wood dust (African maple and ramin)[greater, double equals]20% decline in FEV1 Described in textSkin prick: atopy and specificNot reportedDescribed in text
Serum specific IgENot reportedREIA
Serum total IgENot reportedNot reported
Howe, 1993SIC: lactose powder, TCPA powder, epoxy resin powder, blue pigment powder[greater, double equals]15% decline in FEV1 Described in textSkin prick: atopy and specific5 Wheal diameter >2 mm larger than controlDescribed in text
Serum specific IgE5 Not reportedRAST
Single NSBPT: histamine6 Not reportedNot reported
Huggins, 2003Other: clinical diagnosisIncluded symptoms and/or serum specific IgE and/or SPTNot reportedSerial PFT (PEFR): monitored every 2 hrs for 4 wksVarious definitions: expert interpretation; OASYS-2 score [greater, double equals]2.75; rest-work PEF [greater, double equals]16 L/min; daily variation at work >daily variation awayReferenced (OASYS)
Jager, 1993SIC: latex100% increase in sRaw to at least 5 cm H2O/L/sDescribed in textOther: supervised work challengeNot reportedDescribed in text
Single NSBPT: methacholineNot reportedNot reported
Skin prick: atopy and specificNot reportedDescribed in text
Serum specific IgENot reportedNot reported
Serum total IgENot reportedNot reported
Karol, 1994SIC: TDI[greater, double equals]20% decline in FEV1 Referenced (Mapp et al., 1988)Clinical diagnosisClinical and workplace historyDescribed in text
Single NSBPT: methacholinePD20 FEV1 <1.4 mgReferenced (Chai et al., 1975)
Serum specific IgE>mean + 2SD of control subjectsRAST
Serum specific IgGNot reportedELISA
Serum total IgE>114 IU/mlIgE RIA
Kern, 1991Other: clinical diagnosisBased on criteria for diagnosis of RADSReferenced (Harkonen et al., 1983)Single NSBPT: methacholinePD20 FEV1: no cutoffReferenced (O'conner et al., 1987)
Keskinen, 1988SIC: isocyanates[greater, double equals]20% decline in PEF or 15–19% if other supporting findingsReferenced (Newman-Taylor and Davies, 1981)Skin prick: atopyReaction >1/2 reaction to histamine to at least 1 allergen with negative reaction to dilutantReferenced (Belin and Wass, 1981)
Serum specific IgERatio values [greater, double equals]2 with absorbance reading [greater, double equals]1/2 of the D-reference pointRAST
Kim, 1999SIC: citrus red miteNot reportedDescribed in textSingle NSBPT: methacholinePC20 FEV1 <16 mg/mlReferenced (Chai et al., 1975)
Single PFT: FEV1 Reversibility: [greater, double equals]15% increase in FEV1 Not reported
Skin prick: atopy and specificAllergen:histamine wheal diameter ratio >1Described in text
Serum specific IgEAbsorbance value >0.24ELISA
Serum total IgE[greater, double equals]160 IU/mlDPC kit
Kim, 1997Other: clinical diagnosisIncluded symptoms and serial PFTDescribed in textSingle PFT: FEV1, FVCNot reportedDescribed in text
Serum specific IgECounts per minute of reference disk was >2 times control diskRAST
Serum specific IgGOD ratio >mean +/- 3SD for negative controlELISA
Kongerud, 1992Other: serial PFT>15% variation in diurnal PEFReferenced (Burge, 1982)Clinical diagnosisCriteria proposed by Burge (1982)Described in text
Eosinophils: bloodNot reportedNot reported
Other: symptom scoreNot reportedDescribed in text
Serial NSBPT: methacholine>2 fold change in PC20 FEV1 between work and away periodsReferenced (Cockcroft et al., 1977)
Single NSBPT: methacholinePC20 FEV1 <8 mg/mlReferenced (Cockcroft et al., 1977)
Serum total IgENot reportedNot reported
Kopferschmitt-Kubler, 1998SIC: TDI[greater, double equals]20% decline in FEV1 Described in textSerial PFT (FEV1): monitored at least 3 times/day on a 1 month diary cardNot reportedDescribed in text
Single NSBPT: methacholinePD20 FEV1 <3200 μNot reported
Koskela, 2003SIC: bovine dander>15% decline in FEV1 Not reportedExhaled nitric oxide>46 ppmNot reported
Single NSBPT: histamine or mannitolHistamine: PC20 FEV1 <8mg/mL / mannitol: >15% decrease in FEV1 Referenced (histamine: Cockcroft et al., 1974; mannitol: Anderson et al., 1997)
Skin prick: specificWheal diameter [greater, double equals]3 mmReferenced (Pepys, 1975)
Serum specific IgE>5 IU/LCAP
Serum total IgENot reportedImmulite 2000
Krakowiak, 2003SIC: rodent flour/dust>20% decline in FEV1 Described in textClinical diagnosisIncluded medical history, physical examination and spirometryNot reported
Eosinophils: nasal lavageNot reportedDescribed in text
Single NSBPT: histaminePC20 FEV1: no cutoffReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specificWheal 4mm >control; flare 5mm >controlDescribed in text
Serum specific IgENot reportedRAST
Lam, 1979SIC: red cedar, aerosol inhalation or exposure to work environmentNot reportedReferenced (Chan-Yeung et al., 1973)Single NSBPT: methacholinePC20 FEV1 [less, double equals]16 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopy[greater, double equals]2 positive reactionsNot reported
LaPaglia, 1986SIC: wheat, straw, hay, wood, animal allergens[greater, double equals]15% decline in FEV1 Described in textClinical diagnosisSignificant reduction in FEV1, shortness of breath, wheezing episodesDescribed in text
Skin prick: atopy and specificNot reportedDescribed in text
Larbanois, 2003SIC: suspected agent[greater, double equals]20% decline in FEV1 Referenced (Vandenplas and Malo, 1997)Serial PFT (sGaw): before and after SIC2 cutoff values: >35 decrease; >50% decreaseDescribed in text
Single NSBPT: histaminePC20 FEV1 <16 mg/mlReferenced (Cockcroft et al., 1977)
Lemiere, 2001SIC: suspected agent[greater, double equals]20% decline in FEV1 Referenced (Cartier, 1994)Eosinophils: sputum[greater, double equals]0.26x106 cells/mlReferenced (Pin et al., 1992)
Single NSBPT: methacholinePC20 FEV1 <8 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mm to at least 1 allergen with positive reaction to histamine and negative reaction to diluentNot reported
Liss, 1991SIC: suspected agentNot reportedReferenced (Pepys and Hutchcroft, 1975)Serial PFT (PEFR): monitored 4 times/day for at least 2 wks at work and 2 wks away7 [greater, double equals]20% diurnal variation on at least 2 days with lowest value on a work dayDescribed in text
Single NSBPT: methacholine7 PC20 FEV1 [less, double equals]8 mg/mlReferenced (Juniper et al., 1978)
Single PFT: FEV1 (including reversibility)7 Reversibility: [greater, double equals]15% increase in FEV1 Described in text
Skin prick: atopy and specific7 Wheal diameter >2 mm larger than control [greater, double equals]4 fold shift in PC20 Not reported
Serial NSBPT: methacholine8 FEV1 between after a day at work and after 10 to 14 days off workReferenced (Cockcroft et al., 1977)
Lozewicz, 1985SIC: cyanoacrylate based susbstancesNot reportedNot reportedSingle NSBPT: histaminePC10 FEV1 [less, double equals]32 mgReferenced (DeVries, 1960 and Cockcroft et al., 1977)
Skin prick: atopyNot reportedNot reported
Malo, 1993aSIC: suspected agentNot reportedNot reportedSerial PFT (PEFR): monitored every 2 hrs for 2 wks at work and 2 wks awayNot reportedReferenced (Burge et al., 1979)
Malo, 1991SIC: red cedar, flour, psyllium, guar gum>20% decline in FEV1 Referenced (Pepys and Hutchcroft, 1975)Other: QuestionnaireNot reportedNot reported
Serial NSBPT: histamine or methacholine[greater, double equals]3.2 fold change in PC20 FEV1 between work and awayReferenced (Cockcroft et al., 1977)
Serial PFT (PEFR): monitored every 2 hrs or at least 4 times/dayInterpreted by experienced physiciansReferenced (Burge et al., 1979)
Single NSBPT: histamine or methacholinePC20 FEV1 [less, double equals]16 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopyWheal diameter [greater, double equals]3 mm to at least 1 allergen with positive reaction to histamine and negative reaction to diluentNot reported
Malo, 1990SIC: suspected agentImmediate: [greater, double equals]15% decline in FEV1; late: [greater, double equals]12% decline in FEV1 Referenced (Pepys and Hutchcroft, 1975)Single NSBPT: histamine or methacholinePC20 FEV1 <16 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopyImmediate reaction within 10–15 minutesNot reported
Malo, 1988aSIC: spiromycin[greater, double equals]20% decline in FEV1 Referenced (Pepys and Hutchcroft, 1975)Eosinophils: bloodNot reportedNot reported
Other: questionnaireNot reportedNot reported
Serial PFT (PEFR): monitored 4 times/day and when they had chest symptoms for 2 wks including weekends>20% variationDescribed in text
Single NSBPT: methacholinePD20 FEV1 [less, double equals]16 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopyNot reportedDescribed in text
Mapp, 1986SIC: TDINot reportedDescribed in textSingle NSBPT: methacholinePD20 FEV1 [less, double equals]0.7 mgReferenced (Chai et al., 1975)
Skin prick: atopyNot reportedNot reported
Mapp, 1979SIC: isocyanates>15% decline in FEV1, change in Vmax >20% and change in sGaw >25%Referenced (Fantuzzi et al., 1973)Single NSBPT: carbachol>15% decline if FEV1: no cutoff, change in Vmax >20% and change in sGaw >25%/NDReferenced (Orehek et al., 1977)
Skin prick: atopyNot reportedDescribed in text
Merget, 1997SIC: wheat flour[greater, double equals]50% decline in sGaw after inhalation of 100 mg/ml flour extract, seven cumulative capsules or lessNot reportedSingle NSBPT: methacholinePD50 sGaw [less, double equals]1 mgReferenced (Merget et al., 1994)
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mm larger than saline controlReferenced (Pepys, 1975)
Serum specific IgERAST [greater, double equals]0.35 Phadebus RAST units/mlRAST
Serum total IgENot reportedEnzymun-Test
Merget, 1996SIC: platinum salts[greater, double equals]50% decline in sGaw with platinum salt concentration [less, double equals]0.01 mol/LReferenced (Merget et al., 1991)Single NSBPT: methacholinePD50 sGaw [less, double equals]8 mg/mlReferenced (Merget et al., 1991)
Skin prick: atopy and specificAtopy: wheal diameter [greater, double equals]4 mm / Specific: wheal diameter [greater, double equals]2 mmReferenced (Pepys, 1975)
Serum total IgENot reportedPRIST
Merget, 1993SIC: enzymes[greater, double equals]50% decline in sGaw with enzyme concentration [less, double equals]10mg/mlDescribed in textSingle NSBPT: methacholinePD50 sGaw with dose <mgDescribed in text
Skin prick: atopy and specificWheal diameter [greater, double equals]histamine controlDescribed in text
Serum specific IgE[greater, double equals]0.35 PRUEAST
Serum total IgENot reportedPRIST
Mole, 1977Other: clinical diagnosisIncluded pulmonary function tests, ECG, chest x-ray, and skin prick testsDescribed in textOther: skin patch testNot reportedNot reported
Single NSBPT: acetylcholine>10% decrease in FEV1 Referenced (Sadoul and Aubertin, 1956)
Moller, 1986SIC: TDI[greater, double equals]20% decline in FEV1 Described in textClinical diagnosisClinical and occupational historyDescribed in text
Single NSBPT: methacholinePD20 FEV1: no cutoffDescribed in text
Single PFT: FEV1, FVC, PEFRNot reportedCriteria established by the American Thoracic Society
Moller, 1985Other: physician diagnosisBased on shortness of breath, wheezing or coughing exacerbated at work and/or at night, improvementDescribed in textEosinophils: not reportedNot reportedNot reported
Other: questionnaireNot reportedNot reported
Serial PFT (FEV1): pre- and post- shift>20% decline in FEV1 post-shift compared to pre-shiftDescribed in text
Serum specific IgE[greater, double equals]1 ng/mlSPBRIA
Moscato, 1993SIC: TDI[greater, double equals]15% decline in FEV1 Described in textSingle NSBPT: methacholinePD15 FEV1 <0.85 mgReferenced (Moscato et al., 1991)
Single PFT: FEV1, FVCNot reportedDescribed in text
Skin prick: atopyWheal diameter >5 mmNot reported
Munoz, 2004SIC: potassium persulfate>20% decline in FEV1 more than placebo challengeReferenced (Pepys and Hutchcroft, 1975)Serial PFT (PEFR): monitored every 4 hrs for 2 wks at work and 2 wks awayQualitative assessment revealed evident changes between periodsDescribed in text
Single NSBPT: methacholinePC20 FEV1 <8 mg/mlReferenced (Chai et al., 1975)
Skin prick: atopy and specificAverage of largest and smallest wheal diameter >3mm and more than reaction to histamine controlReferenced (Pepys, 1975)
Serum total IgE>150 IUUniCAP
Nielsen, 1988Other: clinical diagnosisIncluded symptoms during employment and unequivocal and plausible relation to irritant exposureDescribed in textSingle NSBPT: methacholineNot reportedNot reported
Skin prick: atopy and specificWheal area >1/2 of histamine reactionNot reported
Serum specific IgERatio >2.2RAST
Serum specific IgGNot reportedELISA
Serum total IgENot reportedNot reported
Nordman, 1985SIC: formaldehydeImmediate: [greater, double equals]15% decline in PEF; late: [greater, double equals]20% decline in PEFReferenced (Pepys et al., 1972; Newman-Taylor and Davies, 1981)Eosinophils: not reportedNot reportedNot reported
Serial PFT (PEFR): monitored every 3 hrs for at least 24 hrs before SICNot reportedNot reported
Single NSBPT: histamine or methacholineHistamine: [greater, double equals]15% drop in PEF / methacholine: Not reportedReferenced (histamine: Laitinen, 1974; methacholine: Hargreave et al., 1981)
Single PFT: FEV1, FVC (including reversibility)Reversibility: [greater, double equals]15% increase and 150 ml in FEV1 Described in text
Serum total IgENot reportedNot reported
O'Brien, 1979aSIC: isocyanates[greater, double equals]15% decline in FEV1 Described in textSingle NSBPT: histamine[greater, double equals]20% decline in FEV1 [less, double equals]32 mg/mlDescribed in text
O'Brien, 1979bSIC: TDI[greater, double equals]15% decline in FEV1 Described in textOther: exercise test>9% fall in FEV1 or PEFRDescribed in text
Single NSBPT: histaminePC20 FEV1 [less, double equals]32 mg/mlDescribed in text
Skin prick: atopyNot reportedNot reported
Obata, 1999SIC: plicatic acid>20% decline in FEV1 or PEFReferenced (Chan-Yueng et al., 1982)Eosinophils: sputumNot reportedDescribed in text
Exhaled nitric oxideNot reportedDescribed in text
Single NSBPT: methacholinePC20 FEV1 [less, double equals]8 mg/mlReferenced (Lam et al., 1979)
Skin prick: atopyWheal diameter [greater, double equals]3 mm larger than negative controlDescribed in text
Obtulowicz, 1998SIC: suspected agent>20% decline in FEV1 and MEF 25–75%Described in textEosinophils: bloodNot reportedNot reported
Skin prick: atopy and specificNot reportedDescribed in text
Serum total IgENot reportedELISA
Paggiaro, 1987bSIC: plicatic acid>20% decline in FEV1 Referenced (Lam et al., 1983)Single NSBPT: methacholinePC20 FEV1: no cutoff reportedReferenced (Lam et al., 1979)
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mmDescribed in text
Serum specific IgERatio >2.0RAST
Paggiaro, 1986SIC: TDI[greater, double equals]15% decline in FEV1 Described in textSingle NSBPT: methacholinePD20 FEV1 [less, double equals]2 mgDescribed in text
Skin prick: atopyWheal diameter >5 mmNot reported
Paggiaro, 1984bSIC: enzymes>15% decline in FEV1 Described in textSingle NSBPT: bethanechol>15% decline in FEV1: no cutoff reportedReferenced (Parlanti et al., 1983)
Skin prick: atopy and specificWheal diameter [greater, double equals]5 mmDescribed in text
Serum specific IgENot reportedRAST
Serum total IgENot reportedPRIST
Paggiaro, 1984cSIC: isocyanates[greater, double equals]15% decline in FEV1 Referenced (Zedda et al., 1976)Clinical diagnosisPresence of dyspnea, wheezing from exposure to TDI or MDI and a positive response to SICDescribed in text
Single NSBPT: bethanecholPD15 FEV1 [less, double equals]8Described in text
Paggiaro, 1981SIC: wood dust (tanganyika aningre)Not reportedReferenced (Pickering et al., 1972)Single NSBPT: acetylcholine or bethanecholNot reportedNot reported
Skin prick: atopy and specificNot reportedNot reported
Serum specific IgENot reportedRAST
Palczynski, 2003SIC: chloramineNot reportedNot reportedEosinophils: nasal lavageNot reportedReferenced (Greiff et al., 1990)
Single NSBPT: histamineNot reportedReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specificWheal diameter >3 mm larger than negative controlNot reported
Serum specific IgE>35 KU/LRAST
Serum total IgE>35 KU/LRAST
Park, 2002bSIC: porcine pancreatic extract[greater, double equals]20% decline in FEV1 Referenced (Park and Nahm, 1997)Other: immunoblottingNot reportedDescribed in text
Single NSBPT: methacholineNot reportedReferenced (Chai et al., 1977)
Skin prick: specificNot reportedNot reported
Serum specific IgE>mean + 2SD of unexposed controlsELISA
Park, 2001SIC: reactive dyes[greater, double equals]20% decline in FEV1 Not reportedSkin prick: atopy and specificWheal diameter >2 mm larger than negative control and erythema reaction >21 mmDescribed in text
Serum specific IgEOD at 410 >0.013ELISA
Park, 1999SIC: TDINot reportedReferenced (Park et al., 1999)Single NSBPT: methacholinePC20 FEV1: no cutoff reportedReferenced (Park et al., 1999)
Single PFT: not reportedNot reportedNot reported
Skin prick: atopyNot reportedNot reported
Serum specific IgE>mean + 2SD of control subjectsELISA
Park, 1998SIC: grain dust[greater, double equals]20% decline in FEV1 Referenced (Park and Nahm, 1997)Eosinophils: bloodNot reportedSDS-Page
Other: ImmunoblottingNot reportedNot reported
Single NSBPT: methacholinePD20 FEV1 [less, double equals]25 mg/mlReferenced (Chai et al., 1975)
Skin prick: atopy and specificAllergen:histamine area ratio between 0.1 and 1 and erythema >21 mmDescribed in text
Serum specific IgE[greater, double equals]0.064ELISA
Park, 1994SIC: chromium salts[greater, double equals]20% decline in FEV1 Described in textOther: skin patch testNot reportedDescribed in text
Serial PFT (PEFR): monitored every 2 hrs for 2 days at workNot reportedNot reported
Single NSBPT: methacholinePC20 FEV1 [less, double equals]25 mg/mlReferenced (Chai et al., 1975)
Skin prick: atopy and specificNot reportedDescribed in text
Park, 1991SIC: reactive dyes[greater, double equals]20% decline in FEV1 Referenced (Park et al., 1989)Single NSBPT: methacholinePC20 FEV1 [less, double equals]5 mg/mlReferenced (Chai et al., 1975)
Skin prick: atopy and specificAllergen: histamine area ratio between 0.1 and 1 and erythema >21 mmNot reported
Serum specific IgEbinding [greater, double equals]2%RAST
Serum total IgE>160 IU/mlPRIST
Park, 1989SIC: reactive dyes[greater, double equals]20% decline in FEV1 Referenced (Chai et al., 1975)Single NSBPT: methacholinePC20 FEV1: no cutoff reportedReferenced (Chai et al., 1975)
Single PFT: FEV1 Not reportedNot reported
Skin prick: atopy and specificNot reportedDescribed in text
Serum specific IgERAST binding >2%RAST
Perrin, 1990SIC: suspected agentNot reportedNot reportedSerial NSBPT: histamine or methacholine[greater, double equals]2 fold increase in PC20 FEV1 between at work and awayNot reported
Serial PFT (PEFR): monitored every 2 hrs for 2 wks or less at work and 2 wks awayVarious definitions: number of days with [greater, double equals]20% variation in PEFR [greater, double equals]20%; lower maximum PEFR values at work; lower minimum PEFR values at work; lower mean PEFR values at workReferenced (Burge et al., 1979)
Pezzini, 1984SIC: isocyanates[greater, double equals]20% fall in FEV1 or 35% drop in FEF(25–75)Referenced (Zedda et al., 1976)Single NSBPT: bethanecholPD20 FEV1: no cutoffDescribed in text
Skin prick: atopy[greater, double equals]2 positive reactionsReferenced (Vanselow, 1964)
Serum specific IgENBR level >0.9RAST
Prichard, 1984Other: clinical diagnosisIncluded symptoms and physician diagnosed asthma since began working in industryDescribed in textSingle NSBPT: methacholinePD20 FEV1 <30 μDescribed in text
Skin prick: atopy and specificWheal [greater, double equals]3 mm more than negative controlDescribed in text
Quirce, 2000Other: clinical diagnosisIncluded SIC or serial PFTSIC: Referenced (Hinojosa et al., 1984)Skin prick: specificNot reportedDescribed in text
Serum specific IgE[greater, double equals]4 times more serum specific IgE than mean titer of control seraELISA
Quirce, 1992SIC: alpha-amylase from aspergillus oryzae and cellulase from a. niger[greater, double equals]20% decline in FEV1 Described in textSingle NSBPT: methacholineNot reportedReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specificWheal diameter [greater, double equals]3 mmDescribed in text
Serum specific IgENot reportedREIA (alpha-amylase and cellulase) or RAST (wheat and rye)
Rasanen, 1994SIC: suspected agent[greater, double equals]15% decline in FEV1 and PEFRNot reportedOther: basophil histamine release[greater, double equals]8%Referenced (Rasanen et al., 1992)
Skin prick: atopy and specificWheal diameter [greater, double equals]1/2 the size of the reaction to histamine standardDescribed in text
Serum specific IgE[greater, double equals]0.7 kU/LRAST
Serum total IgENot reportedIgE RIA
Redlich, 1996SIC: isocyanatesNot reportedNot reportedEosinophils: bloodNot reportedDescribed in text
Other: bronchial alveolar lavageNot reportedDescribed in text
Single NSBPT: methacholineNot reportedNot reported
Ricciardi, 2003SIC: wood dust (iroko)[greater, double equals]25% decline in FEV1 Referenced (Frolund, 1996)Eosinophils: bloodNot reportedDescribed in text
Serial PFT (PEFR): monitored every two hrs for 1 wk at work and 1 wk awayNot reportedNot reported
Single NSBPT: methacholine[greater, double equals]20% decline in FEV1: no cutoffNot reported
Skin prick: atopy and specificWheal diameter >7 mmDescribed in text
Serum specific IgENot reportedRAST
Serum total IgENot reportedRAST
Sander, 2001SIC: wheat and ryeNot reportedNot reportedSkin prick: specific[greater, double equals]1/2 of histamine whealDescribed in text
Sastre, 2003SIC: isocyanates[greater, double equals]20% decline in FEV1 Not reportedSingle NSBPT: methacholinePC20 FEV1 <16 mg/mlReferenced (Cockcroft et al., 1977)
Schuermans, 2003SIC: latexNot reportedNot reportedSingle NSBPT: histaminePC20 FEV1 <0.5 mg/mlNot reported
Schwaiblmair, 1997SIC: bleaching powder[greater, double equals]100% increase in specific airway resistance and reached at least 2.0 kPa/sDescribed in textSingle NSBPT: methacholine[greater, double equals]100% increase in specific airway resistance and reached 2.0 kPaReferenced (Hargreave et al., 1981)
Single PFT: FVC, MEF50, FEV1, RV, TLco, Raw Pa02 Not reportedDescribed in text
Skin prick: atopy and specificWheal diameter >3 mm larger than negative controlReferenced (Pepys, 1975)
Schwarting, 1979SIC: flourNot reportedNot reportedClinical diagnosisIncluded medical history, skin prick test, bronchial provocation test, nasal provocation, conjuctivities, and serum specific IgEDescribed in text
Skin prick: specificNot reportedNot reported
Serum specific IgENot reportedRAST
Shirai, 2003SIC: epigallocatechin gallate (EGCg)[greater, double equals]20% decline in FEV1 Referenced (Shirai et al., 1997)Clinical diagnosisClinical history, postive SIC, positive SPTDescribed in text
Single NSBPT: methacholinePC20 FEV1 <10 mg/mlReferenced (Makino et al., 1984
Skin prick: specificWheal diameter >7 mmDescribed in text
Shirakawa, 1988SIC: cobalt chlorideNot reportedReferenced (Chai et al., 1975)Eosinophils: blood>200/mm3 Not reported
Other: antibodies (CO-HSA)Not reportedReferenced (Ouchterlony, 1968)
Single NSBPT: methacholineNot reportedReferenced (Hargreave et al., 1981)
Skin prick: specificWheal diameter >9 mm at <0.1%Not reported
Serum specific IgE>673 cpm (upper normal limit)RAST
Slovak, 1981Other: clinical diagnosisBased history of repeated episodes of wheezing or chest tightness (with or without cough) related toDescribed in textSerial PFT (PEFR): monitored every 2 hrs while awake for 3 mosNot reportedNot reported
Skin prick: atopy and specificWheal diameter >3 mmDescribed in text
Symington, 1981SIC: mushroom dustNot reportedDescribed in textSkin prick: atopy and specificWheal diameter [greater, double equals]3 mmDescribed in text
Tabar, 2004SIC: asparagus[greater, double equals]20% decline in FEV1 Described in textOther: immunoblottingNot reportedNot reported
Skin prick: atopy and specificWheal area [greater, double equals]7 mm2 Referenced (Dreborg, 1993)
Serum specific IgENot reportedNot reported
Serum total IgENot reportedNot reported
Taivainen, 1994SIC: cow danderImmediate: [greater, double equals]15% change in PEFR; late: [greater, double equals]20% change in PEFRDescribed in textClinical diagnosisDescribed in textDescribed in text
Skin prick: specificTwo cutoff values: wheal diameter [greater, double equals]3 mm or >than positive controlDescribed in text
Serum specific IgETwo cutoff values: [greater, double equals]0.35 kU/L or [greater, double equals]0.70 kU/LRAST
Tee, 1998Other: clinical diagnosisIncluded SIC and/or clinical history and/or serial PFT and/or NSBPTSIC: Referenced (Newman-Taylor and Davies, 1981)Skin prick: atopyWheal diameter >3 mmNot reported
Serum specific IgETwo cutoff values: ratio [greater, double equals]2; ratio [greater, double equals]3RAST
Tse, 1982SIC: plicatic acidNot reportedReferenced (Chan-Yeung et al., 1973)Serum specific IgE>mean + 2SD of control subjectsRAST
Vandenplas, 2001SIC: latex[greater, double equals]20% decline in FEV1 Referenced (Vandenplas et al., 1995)Clinical diagnosisQuestionnaire and clinical history with OA considered likely or highly likely on the basis of consensus assessment by 4 observersDescribed in text
Serial NSBPT: histamine>3 fold change in PC20 FEV1 before and after SICReferenced (Cockcroft et al., 1977)
Single NSBPT: histaminePC20 FEV1 <16 mg/mlReferenced (Cockcroft et al., 1977)
Skin prick: atopy and specific[greater, double equals]1 positive reactionReferenced (Vandenplas et al., 1995)
Vandenplas, 1995bSIC: latex[greater, double equals]20% decline in FEV1 Described in textSingle NSBPT: histaminePC20 FEV1 <16 mg/mlDescribed in text
Skin prick: atopy and specificWheal [greater, double equals]3mm greater than controlDescribed in text
Vanhanen, 2000SIC: cellulase (econase ECP)[greater, double equals]15% decline in FEV1 Not reportedSingle NSBPT: histaminePD15 FEV1 [less, double equals]1.6 mgReferenced (Sovijarvi et al., 1993)
Skin prick: atopy and specificNot reportedReferenced (Vanhanen et al., 1996)
Serum specific IgE>35 KU/LRAST
Virtanen, 1996Other: clinical diagnosisIncluded SIC and/or SPT and/or serum specific IgESerum specific IgE: described in textSerum specific IgENot reportedELISA
Serum specific IgGNot reportedELISA
Vogelmeier, 1991SIC: TDI[greater, double equals]50% decline in sGaw from the zero valueReferenced (Dharmarajan and Rando, 1979; O'Brien et al. 1979)Single NSBPT: methacholine[greater, double equals]50% decline in specific airway conductanceDescribed in text
Skin prick: specificNot reportedNot reported
Serum specific IgENot reportedRAST
Wurzinger, 1997SIC: flourNot reportedDescribed in textSingle NSBPT: histamineNot reportedDescribed in text
Skin prick: atopy and specificNot reportedDescribed in text
Serum specific IgENot reportedRAST
Serum total IgENot reportedELISA
Zeiler, 2002SIC: Bos d2 and standard bovine dander allergen[greater, double equals]15% decline in FEV1 or PEFDescribed in textSingle NSBPT: histaminePD15 FEV1 <1.6 mgReferenced (Sovijarvi et al., 1993)
Skin prick: specificWheal diameter [greater, double equals]3 mmDescribed in text
Serum specific IgENot reportedRAST and ELISA
Serum specific IgGNot reportedELISA
Zeiss, 1977Other: clinical diagnosisIncluded history, physical, and skin tests when indicatedDescribed in textSkin prick: atopy and specificNot reportedNot reported
Serum specific IgENot reportedPTRIA
Serum specific IgGNot reportedPTRIA

Abbreviations: CAP = developed by Pharmacia Diagnostics for measuring specific IgE; cbu = cumulative breath unit; CO-HSA = conjugated human serum albumin; cpm = counts per minute; DPC = diagnostics products corp.; EAST = enzyme allergosorbent test; ECG = electrocardiogram; ECP = eosinophilic cationic protein; ECSC = European coal and steel community; ELISA = enzyme-linked immuno sorbent assay; FEF = forced expiratory flow; FEV 1 = forced expiratory volume in one second; FVC = forced vital capacity; kPa = kilopascal; MCP-1= monocyte chemoattractant protein-1; MEF = maximal expiratory flow; mos = months; NSBPT = non-specific bronchial provocation; OASYS-2 = occupational asthma system; OD = optical density; PC 20 = provocative concentration causing a 20% drop in FEV1; PaO 2 = arterial oxygen partial pressure; PD 15 = provocative dose causing a 15% drop in FEV1; PD 50 = provocative dose causing a 50% drop in FEV1; PD 20 = provocative dose causing a 20% drop in FEV1; PEF = peak expiratory flow; PEFR = peak expiratory flow rate; PFT = pulmonary function test; PRIST = paper radioimmunosorbent test; PRU = phadebas RAST units; PTRIA = polystyrene-tube radioimmunoassay; RADS = reactive airways dysfunction syndrome; RAST = radio allegro sorbent test; REIA = reverse enzyme immunoassay; RIA = radioimmunoassay; RIACT = radioimmunoassay kit for measuring IgE; RV = residual volume; SD = standard deviation; SDS = sodium dodecyl sulphate; sGaw = specific airway conductance; SIC = specific inhalational challenge; SOB = shortness of breath; SPBRIA = solid-phase bead radioimmunoassay; sRaw = specific airway resistance; TCPA = tetrachlorophthalic anhydride; TDI = toluene di-isocyanates; TDI-HSA = toluene di-isocyanates human serum albumin; TLco = single breath carbon monoxide; IU = international units; UniCAP = fluoroenzymeimmunoassay kit developed by Pharmacia Diagnostics; Vmax = maximum flow; wk = week; wks = weeks

From: Appendix E: Evidence Tables

Cover of Diagnosis and Management of Work-Related Asthma
Diagnosis and Management of Work-Related Asthma.
Evidence Reports/Technology Assessments, No. 129.
Beach J, Rowe BH, Blitz S, et al.

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