Are we failing workers with symptoms suggestive of occupational asthma?

Aims: To assess the route to secondary care for patients with possible occupational asthma, and to document the duration of workrelated symptoms and referral times.

Methods: Consecutive patients with suspected occupational asthma were recruited to a case series from six secondary care clinics with an interest in occupational asthma. Semi-structured interviews were performed and hospital case notes were reviewed to summarise relevant investigations and diagnosis.

Facilities for investigating occupational asthma in UK non-specialist respiratory departments.

Background: The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts.

Aims: This study aimed to investigate whether these facilities are available in UK non-specialist secondary care respiratory departments and to document tertiary care referral patterns.

Methods: A random sample of 100 UK respiratory units was selected, and the lead consultant invited to participate.

Occupational asthma: an assessment of diagnostic agreement between physicians.

Objectives: To investigate the levels of agreement between expert respiratory physicians when making a diagnosis of occupational asthma.

Methods: 19 cases of possible occupational asthma were identified as part of a larger national observational cohort. A case summary for each case was then circulated to 12 physicians, asking for a percentage likelihood, from the supplied information, that this case represented occupational asthma.

Reproducibility and validity of a Yan-style portable citric acid cough challenge.

Although many different methods of measuring cough reflex sensitivity have been published, few are simple enough to use outside of a hospital or laboratory environment. The aim of this study was to develop a simple, quick, and portable cough challenge, assess its reproducibility, and compare its results with those measured by an existing established hospital protocol. Twenty-five volunteers performed cough challenges based on an established hospital dosimeter protocol, and, on a separate occasion, by a protocol inhaling citric acid from DeVilbiss 40 hand-held nebulisers (citric acid concentrations of 10-3000 mM).

Immunologic response to inhaled endotoxin: changes in peripheral cell surface markers in normal individuals.

Monocyte cell surface CD14 increases following both in vitro challenge with lipopolysaccharide (LPS) and exposure to organic dusts. We investigated 9 volunteers, mean age 39 years (range, 29-53 years). Each inhaled increasing concentrations of lipopolysaccharide (0.