Abstract
Allergologie select, Vol. 5/2021 (315-334)
Workplace-related inhalation test (AIT) – Specific inhalation challenge (SIC) – S2k Guideline of the German Society for Occupational and Environmental Medicine e.V. (DGAUM), the German Society for Pneumology and Respiratory Medicine e.V. (DGP)
Alexandra M. Preisser1, Dirk Koschel2, Rolf Merget3, Dennis Nowak4, Monika Raulf3, and Jan Heidrich1
1Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, 2Department of Internal Medicine and Pneumology, Fachkrankenhaus Coswig, Lung Center, Coswig, Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, 3Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, and 4Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, CPC Comprehensive Pneumology Center Munich, DZL, Deutsches Zentrum für Lungenforschung Munich, Germany
Correspondence to:
PD Dr. med. Alexandra M. Preisser, Arbeitsgruppe Klinische Arbeitsmedizin, Zentralinstitut für Arbeitsmedizin und Maritime Medizin (ZfAM), Universitätsklinikum Hamburg-Eppendorf (UKE), Seewartenstraße 10, Haus 1, 20459 Hamburg, Germany
Email: [email protected]
Abstract
Allergologie select, Vol. 8/2024 (90-198)
AWMF mold guideline “Medical clinical diagnostics for indoor mold exposure” – Update 2023 AWMF Register No. 161/001
Julia Hurraß1,a,b, Birger Heinzow2,a, Sandra Walser-Reichenbach3,a,b, Ute Aurbach4,5,a, Sven Becker6,a, Romuald Bellmann7,a, Karl-Christian Bergmann8,a,b, Oliver A. Cornely9,a, Steffen Engelhart10,a,b, Guido Fischer11,a, Thomas Gabrio12,a, Caroline E.W. Herr3,13,a,b, Marcus Joest14,a, Christian Karagiannidis15,16,a, Ludger Klimek17,a,b, Martin Köberle18,a,b, Annette Kolk19,a, Herbert Lichtnecker20,a, Thomas Lob-Corzilius21,a,b, Norbert Mülleneisen22,a,b, Dennis Nowak23,a,b, Uta Rabe24,a,b, Monika Raulf25,a,b, Jörg Steinmann26,a, Jens-Oliver Steiß27,28,a,b, Jannik Stemler9,a, Ulli Umpfenbach29,a, Kerttu Valtanen30,a, Barbora Werchan31,a, Birgit Willinger32,a,b, and Gerhard A. Wiesmüller4,5,33,a,b
1Section for Hygiene in Healthcare Facilities, Division of Infection Control and Environmental Hygiene, Cologne Health Department, Cologne, 2Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel, 3Bavarian Health and Food Safety Authority, Munich, 4Laboratory Dr. Wisplinghoff, 5ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne, 6Department for Otorhinolaryngology, Head and Neck Surgery, University Medical Center Tübingen, Tübingen, Germany, 7Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria, 8Institute of Allergology Charité, Charité – University Medicine Berlin, Berlin, 9Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne, 10Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, 11Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart, 12Formerly: Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart, 13Environmental Health and Prevention, Institute and Polyclinic for Occupational, Social and Environmental Medicine, University of Munich Hospital Ludwig-Maximilians-University, Munich, 14Allergological-Immunological Laboratory, Helios Lung and Allergy Center Bonn, Bonn, 15Faculty of Health, Professorship for Extracorporeal Lung Replacement Procedures, University of Witten/Herdecke, Witten/Herdecke, 16Lung Clinic Cologne Merheim, Clinics of the City of Cologne, Cologne, 17Center for Rhinology and Allergology, Wiesbaden, 18Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, 19Institute for Occupational Safety and Health (IFA) of the German Social Accident Insurance (DGUV), Unit Biological Agents, Sankt Augustin, 20Medical Institute for Environmental and Occupational Medicine MIU GmbH Erkrath, Erkrath, 21Scientific working group of environmental medicine of the German Society of Pediatric Allergology (GPAU), 22Asthma and Allergy Center Leverkusen, Leverkusen, 23Institute and Polyclinic for Occupational, Social and Environmental Medicine, member of the German Center for Lung Research, Hospital of the University of Munich, Munich, 24Center for Allergology and Asthma, Johanniter Hospital Treuenbrietzen, Treuenbrietzen, 25Institute for Prevention and Occupational Medicine of the German Statutory Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, 26Center for Pediatrics and Adolescent Medicine, University Hospital Giessen and Marburg GmbH, Giessen, 27Specialized Practice in Allergology and Pediatric Pulmonology in Fulda, Fulda, 28Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Private Medical University Nuremberg Clinic, Nuremberg, 29Doctor for Pediatrics and Adolescent Medicine, Pediatric Pulmonology, Environmental Medicine, Classical Homeopathy, Asthma Trainer, Neurodermatitis Trainer, Viersen, 30FG II 1.4 Microbiological Risks, German Environment Agency, Berlin, 31German Pollen Information Service Foundation (PID), Berlin, Germany, 32Department of Laboratory Medicine, Division of Clinical Microbiology – Medical University of Vienna, Vienna, Austria, and 33Institute for Occupational, Social and Environmental Medicine, Uniclinic RWTH Aachen, Aachen, Germany, aCo-author, bMember of a scientific medical society, a society or a medical association with voting rights
Correspondence to:
Dr. rer. nat. Julia Hurraß, Hygiene in Health Care Facilities, Department of Infection and Environmental Hygiene, Cologne City Health Department, Neumarkt 15 – 21, 50667 Cologne, Germany
Email: [email protected]
Abstract
Allergologie select, Vol. 10/2026 (234-258)
S2k-Guideline – Standardized application of the nasal and conjunctival provocation test on allergic diseases of the upper airways
Ulrike Förster-Ruhrmann1, Tobias Ankermann2, Sven Becker3, Petra Bubel4, Mandy Cuevas5, Moritz Gröger6,7, Ludger Klimek8, Lars Lange9, Katrin Milger10,11, Philip Maier12, Norbert Muelleneisen13, Dennis Nowak14, Heidi Olze1, Uwe Pleyer15, Wolfgang Schlenter16, Sebastian Schmidt17, Antje Schuster18, Martin Wagenmann19, Bettina Wedi20, and Oliver Pfaar21
1Department of Otorhinolaryngology, CCM and CVK, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, 2Childrens Hospital, Städtisches Krankenhaus Kiel gGmbH, Kiel, 3Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center, Tübingen, 4ENT practice Dr. Bubel, Eisleben, 5Faculty of Medicine and University Hospital Carl Gustav Carus, Department of Otorhinolaryngology Head and Neck Surgery, TUD Dresden University of Technology, Dresden, 6Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig Maximilian University of Munich, Munich, 7HNO am Maximiliansplatz, Munich, 8Center for Rhinology and Allergology, Wiesbaden, 9Department of Pediatrics, GFO-Kliniken Bonn, St. Marien-Hospital, Bonn, 10Department of Medicine V, University Hospital of the Ludwig Maximilian University Munich, Munich, Germany, 11Division of Respiratory Medicine, Department of Internal Medicine, Medical University of Graz, Austria, 12Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, 13Asthma-Allergiezentrum, Leverkusen, 14Institute and Clinic for Occupational, Social and Environmental Medicine, CPC (Comprehensive Pneumology Center) Munich, DZL, German Center for Lung Research, Munich, 15Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, 16Langenselbold, 17Department of Pediatrics, University Medicine, Greifswald, 18Center for Paediatric and Adolescent Medicine, University Medical Center, Düsseldorf, 19Department of Otorhinolaryngology, Düsseldorf University Hospital (UKD), Düsseldorf, 20Department of Dermatology and Allergy, Comprehensive Allergy Center, Hanover Medical School, Hannover, and 21Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
Broad evidence confirms that AR (ICD J30.3) is a chronic disease with high prevalence among children and adults worldwide. Its consequences, both from a public health perspective and at the level of the individual patient, are often underestimated, and the condition is inadequately treated. In addition, AR is often related to comorbidities with additional impact on diseases-severity. Allergen provocation of the easily accessible nasal (nasal allergen provocation test: NPT) or conjunctival mucosa (conjunctival allergen provocation test: CPT) reproduces the allergen-dependent, IgE-mediated allergic reaction under controlled and standardized conditions. These measures are regarded as the diagnostic gold standard, particularly in cases of unclear results in primary allergological tests, enabling clinically relevant identification of the causative allergen. Approved test allergens are critical for ensuring the methodological quality of the NPT. However, their availability is increasingly limited, although adequate quantities of allergen solutions remain indispensable for high-quality nasal allergen testing. Unilateral allergen provocation has been established in the clinical routine for decades in Germany. However, scientific evidence for unilateral application of the test allergen is pending. International position papers differ from this recommendation. The CPT is a simple, safe, and well-tolerated measure. It is primarily used in perennial and, in selected cases, seasonal allergic conjunctivitis. This method is less commonly applied for vernal keratoconjunctivitis and atopic keratoconjunctivitis. It is primarily used to confirm the underlying allergen, particularly when establishing the indication for allergen immunotherapy (AIT). It can also be employed to monitor treatment effects such as e.g., AIT or pharmacotherapy. Although highly sensitive, the procedure of nasal ASA provocation remains a time-consuming procedure. While challenging in children, NPT provides clinically relevant additional diagnostic information on the causes of the allergic symptoms. Allergological diagnostic work-up also includes pulmonary assessment, particularly in patients with established asthma or symptoms suggestive of asthma. Both AAR and PNIF are applied as standard procedures for assessing the outcome of NPT in Germany. In individual cases, other rhinometric methods may also be used.Correspondence to:
Dr. Ulrike Förster-Ruhrmann, Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany, And Prof. Dr. Oliver Pfaar, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043 Marburg, Germany
Email: [email protected]
