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Spirometry and non-specific bronchial responsiveness should be measured, but carefully performed and validly analysed serial peak expiratory flow or forced expiratory volume in one second (FEV) measurements are more specific and confirm occupational asthma in about 82% of those still exposed to the causative agent.Skin prick testing or specific immunoglobulin E assays are useful to document allergy to high molecular weight allergens.
Several epidemiological questionnaires are in current use [26–28].
Questions about work exposure and association of symptoms to work may be used in clinical diagnosis.
All working patients with asthma and COPD should be asked whether their symptoms improve on days away from work or on holidays.