[Occupational olfactory changes: diagnostic trends]

Olfactory testing has been of minor interest in Occupational Health due to the lack of testing methods able to detect malingering. On the other hand there is evidence that occupational exposure to several, mainly neurotoxic, substances may result in olfactory damage. We have combined three different testing methods in one package in order to assure a forensic-degree level of results. The package consists of: 1. primary neuron functionality testing with a single olfactory stimulant; 2. olfactory-trigeminal discrimination testing with regular sniff-test; 3. odor identification score by Doty's UPSIT test. Final judgement of a link between olfactory system impairment and occupational exposure to chemicals requires a good knowledge of the present and past occupational exposure and of the general conditions of the patient. It requires collaboration between the Occupational Health specialist and the expert in Olfactology and may be completed with endoscopy, radiography and other specific controls. We suggest that a more extensive use of appropriate olfactory testing should be established at least for special risk groups of workers. This will not only detect occupational health damage that would otherwise have remained unknown, but can also furnish new information on the neurotoxic effects of many inhalable chemicals.