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Dyspnea, wheezing, and/or cough that correlate with the workplace
Patients often report feeling better in the evenings or during weekends and vacations
Symptoms may occur 4–8 hours after exposure to the offending antigen. This may occur after the patient has left work or even at night and thus may mimic paroxysmal nocturnal dyspnea
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Requires a high index of suspicion and a careful history of workplace exposures
Spirometry before and after exposure to the implicated substance
Peak flow measurements at and outside of the workplace
Bronchoprovocation testing is helpful in some cases
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