Abstract
Several recent investigations demonstrate that approximately 10% of all asthma and COPD diseases are caused by occupational exposures to allergens or irritants. This review covers the stepwise diagnostic procedure. Of special importance is the initial, detailed clinical and occupational history supplemented by lung function testing including the measurement of unspecific bronchial hyperreagibility, allergological examinations (skin prick testing, measurement of specific IgE antibodies) and avoidance/reexposure tests. Furthermore, the specific inhalative challenge test with its variant, the occupational-type inhalative exposure test, as gold standard is described in detail. Its indications and contraindications are given. If the occupational history reveals a pneumoconiosis risk, chest X-ray examinations are required. A definitive diagnosis is obligatory due to legal aspects with regard to insurance (is there evidence for an occupational disease?) and for the initiation of aimed preventive measures.
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