To the Editor:
Asthma is described as “occupational” if it has been induced by an agent encountered in the workplace. The avoidance of further exposure to the causative agent often results in resolution of the asthma, especially if it can be achieved soon after the onset of symptoms [1]. Consequently, occupational asthma is one of the very few types of asthma that are potentially curable.
The implications of this include the importance of early recognition of occupational asthma and of accurate identification of the causative agent. A variety of methods are available to make a diagnosis [2], among which specific inhalation challenge (SIC) testing is generally considered to be the reference standard [3–5]. In this context, SIC testing is the controlled exposure of a patient, under laboratory conditions, to an agent encountered in their workplace. The technique is complex, specialised and practised only in a limited number of centres. If performed carefully it is an effective, efficient and low-risk strategy for making (or in some cases refuting) a diagnosis of occupational asthma and for identifying a specific causal exposure.
In 2011, we established a Task Force on occupational SIC testing, comprising 15 specialist physicians from 10 European countries; funding was granted by the European Respiratory Society (ERS). Our principle aim was to issue guidance on the indications, methodology and interpretation of SIC tests for those who already provide the service and for those who wish to do so in the future. The work programme included a survey of European centres where SIC testing is currently offered; here we present a summary of the responses to this survey.
Members of the Task Force devised a 40-item questionnaire designed to enquire about the experience and practice of occupational SIC over the previous 3 years. …