Donoghue emphasizes the importance of recognizing occupational asthma in the initial assessment of adult patients with airway hyperresponsiveness. The frequency of this disorder, its economic impact on both the employee and the employer, its resolution with proper diagnosis, and change in exposure to the substance(s) involved, demands consideration in any patient whose asthma may be associated with the workplace.
His comments about diagnosing and, therefore, more properly treating patients with occupational asthma actually draw into focus the importance of uncovering any etiologic factor that is involved in acute or chronic asthma. This is the approach of allergists who are trained to take a detailed history, emphasizing provocative factors, whether at home, school, work, or play. In certain patients, appropriate tests, such as determining the presence of specific IgE antibodies and/or provocative tests with antigens, exercise, or cold air, can clarify or confirm a diagnosis. These evaluations can be important not