Second, it is necessary to obtain objective confirmation of the diagnosis by various means whenever feasible. A compatible history of OA, such as improvement of symptoms when away from work and worsening on returning to work, is very sensitive but not specific.11 Because removal from the job is required when a diagnosis of OA due to occupational sensitizers has been made, and as this may cause considerable financial loss and economic distress,12 optimizing objective testing is critical. Since most objective testing, such as serial peak expiratory flow monitoring and work place challenge testing, is best done while the subject is still working, it is important that the diagnosis of OA be completed before asking the patient to leave the job (when proven necessary). Often patients are seen when they have left their jobs and may have completely or partially recovered, making objective testing much more difficult and at times not possible. A caveat to this not mentioned in the new statement, given that ongoing work exposure can considerably increase the long-term health impact of OA, is the urgency of the diagnostic process. Prolonged deliberations in arranging for the critical diagnostics should be avoided. For irritant-induced asthma, however, work relationship is best obtained by history.