1a. Occupational Asthma: Specific Inhalational Challenge tests are used to confirm the diagnosis of Occupational Asthma
| Gage Occupational and Environmental Health Unit, University of Toronto, Toronto, Canada |
Dr. Susan M. Tarlo, Pulmonary Medicine |
| Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada |
Drs. Jean-Luc Malo and Alain Desjardins, Pulmonary and Critical Care |
| University of Alberta Occupational Health Program Edmonton, Alberta, Canada |
Dr. Jeremy Beach, Occupational Medicine |
| Hamilton Health Sciences, Hamilton, Ontario, Canada |
Dr F.E. Hargreave, Pulmonary Medicine |
| University of Saskatchewan, Saskatchewan, Canada |
Dr Don Cockcroft, Pulmonary Medicine |
Many of the centers offer only a limited number of specific challenges, so detailed discussion of the individual case prior to referral is essential.
1. b) Occupational Asthma: Serological tests
| Northwestern University Department of Medicine, Division of Allergy, Chicago, Illinois |
IgE & IgG antibodies against isocyanates, phthalic anhydride, trimellitic anhydride | Dr. Leslie C. Grammer |
| University of Cincinnati College of Medicine, Division of Immunology and Allergy, Cincinnati, Ohio |
IgE & IgG antibodies against isocyanates | Dr. David I. Bernstein |
|
Yale Occupational and Environmental Medicine Program, |
Occupational Medicine: Isocyanate inhalational challenge chamber | Carrie Redlich |
Other reference laboratories listed in section 4 also provide extensive testing for IgE antibodies against several occupational and environmental causes.
2. Chronic beryllium Lung Disease: Beryllium lymphocyte transformation test
Beryllium lymphocyte transformation testing can be done on blood and broncho-alveolar lavage fluid to evaluate sensitization to beryllium in suspected cases of chronic beryllium lung disease. It also helps to detect sensitization to beryllium exposure in the past or present; and demonstrate the effectiveness of exposure control efforts.
| National Jewish Medical and Research Center, Denver, Colorado | Lisa Maier, MD |
| The Cleveland Clinic Foundation, Cleveland, Ohio | Dr. Raed Dweik |
| In addition, Los Alamos National Laboratory, Los Alamos, New Mexico, and Oak Ridge Institute for Science and Education (ORISE), Tennessee are conducting testing for the U.S. Department of Energy facilities. |
3) Pneumoconiosis: Analytical Electron microscopy for inorganic dusts
Several laboratories in North America provide analytical electron microscopy services for documenting inorganic dust content.
| Durham VA Medical Center Department of Pathology, Duke University, Durham, North Carolina | Dr. Victor Roggli |
| University of British Columbia Department of Pathology & Laboratory Medicine, Vancouver, British Columbia, Canada | Dr. Andrew Churg |
| State University of New York Department of Pathology, Syracuse, New York | Dr. Jerrold Abraham |
| McGill University Department of Pathology, Montreal, Quebec, Canada | Dr. Bruce W. Case |
4) Hypersensitivity Pneumonitis: Serological tests for precipitins
Precipitins are usually of the IgG or IgM antibody classes, and result from exposure of the patient's immune system to an antigen. Among other things, the measurement of precipitins may be useful in diagnosis of hypersensitivity pneumonitis. These laboratories offer a comprehensive panel of test against various antigens, including those that are unusual and 'exotic'. If the desired antigen is not on this list, please call the laboratory to see if it can be obtained.
| National Jewish Medical and Research Center, Denver, Colorado also performs assessment of environmental antigens such as dust analysis | |
| Specialty Laboratories, Santa Monica, California provides an extensive array of RAST testing | |
| Northwestern University Department of Medicine, Division of Allergy, Chicago, Illinois offers testing for IgG antibodies against isocyanates, phthalic anhydride, trimellitic anhydride | |
| Mayo Medical Laboratory, Mayo Clinic, Rochester, Minnesota has an on-line catalog of specialized diagnostic tests | |
| Associated Regional and University Pathologists (ARUP) Laboratories at the University of Utah Health Sciences Center, Salt Lake City, Utah has a market focus to perform esoteric testing that supplements the testing available in local communities. |
