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Dyspnea, wheezing, cough, or a combination of all that correlate with exposure to the workplace
Offending agents can be classified into low-molecular weight (eg, isocyanates, metals, wood dust, dyes and bleaches, resins and glues) and high-molecular weight (eg, animal proteins; flours; enzymes such as pancreatic extracts; plant-based proteins such as wheat, coffee beans, tobacco) chemicals
Patients often report feeling better in the evenings or during weekends and vacations
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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
Bronchial provocation testing is helpful in some cases
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