Usefulness of nasal provocation tests in occupational rhinitis

The aim of the study was to determine whether Nasal Provocation Tests (NPT) could help in the diagnosis of occupational rhinitis (OR).

Changes in nasal airway resistance (NAR), measured by posterior rhinomanometry during specific nasal challenge associated with per and post test clinical scores, were compared to a prior probability, based on the patient's history, determined by occupational physicians, in 41 hairdressers and 33 bakers referred for suspected OR.

A DeltaNAR >or= 150% defined the positivity of the NPT. DeltaNAR demonstrated 50% sensitivity and a 86% specificity in hairdressers and a 95% sensitivity with 100 % specificity in bakers. DeltaNAR presented significant positive correlations with both per (p = 0.0003, r = 0.48) and post test clinical scores (p < 0.005, r = 0.39). The addition of clinical scores increased the sensitivity to 100% in hairdressers with 81% specificity.

The NPT constitutes a safe procedure of nasal reactivity with good levels of sensitivity and specificity in both hairdressers and bakers when nasal resistance and clinical scores are taken into account.