Introduction : L’asthme professionnel (AP) est diagnostiqué au Québec avec le test de provocation bronchique spécifique (TPS). Le TPS consiste à exposer le patient à un agent causal suspecté en vue de provoquer une réaction asthmatique. Un TPS négatif est possible quand un agent causal a été omis de l’histoire professionnelle du patient. L’évaluation des expositions professionnelles par une expertise en hygiène en santé du travail est considérée comme une méthode précise, lorsque des données de mesure ne sont pas disponibles. Cependant, l'apport de cette méthode dans le diagnostic de l’AP n'a jamais été examiné dans un contexte clinique. Objectifs : Déterminer l'apport de l'évaluation des expositions professionnelles par une expertise en hygiène du travail dans l'investigation de l'AP. Comparer les expositions professionnelles détectées par un clinicien et par un hygiéniste chez 1) des sujets avec de l’AP prouvé par des TPS positifs, 2) chez des sujets avec des TPS négatifs. Méthodes : Une analyse des expositions potentielles par le clinicien a précédé la réalisation du TPS. Une évaluation des expositions professionnelles a été réalisée par un hygiéniste. L’hygiéniste n’avait pas connaissance du diagnostic du patient. Résultats : 120 sujets (TPS positifs : 67 négatifs :53) ont été enrôlés dans l’étude. L’hygiéniste a identifié l’agent causal dans la très grande majorité des TPS positifs. Dans 33 TPS négatifs, l’hygiéniste a détecté des agents sensibilisants non identifiés par le médecin. Conclusion : L’évaluation des expositions professionnelles par une expertise en hygiène du travail est une méthode pouvant compléter l'évaluation clinique pour la détection d’agents sensibilisants associés à l’AP. L’inclusion de cette approche dans l’évaluation clinique de l’AP aurait comme effet de réduire la survenance d’un diagnostic erroné. / Introduction: Occupational asthma (OA) is diagnosed in the province of Quebec with the specific inhalation challenge (SIC) test. The SIC test consists of exposing the patient to a suspected causal agent in order to induce an asthmatic reaction. When a causal agent has been omitted from the occupational history, the SIC test can be negative. An expert assessment of occupational exposures by an occupational hygienist is considered an accurate method when quantitative measurements are not available. However, its contribution has never been evaluated in the diagnosis of OA. Objective: Evaluate the contribution of an occupational exposure assessment by an expert industrial hygienist to the diagnosis of OA. Compare the occupational exposures detected by an occupational hygienist and a clinician in: 1) OA subjects with a positive SIC, 2) Subjects with a negative SIC. Methods: The clinician assessed the workplace exposures during a routine clinical evaluation preceding the performance of the SIC. An expert assessment of work histories was performed by an occupational hygienist blind to the diagnostic status of the patient. Results: 120 subjects (Positive SIC: 67 Negative SIC: 53) were enrolled in this study. The occupational hygienist detected the causal agent in almost all cases of OA. In 33 negative SIC, the occupational hygienist identified sensitizing agents which were not detected by the clinician. Conclusions: An expert assessment of occupational exposures by an occupational hygienist is a method which could complement the clinical assessment for the detection of sensitizing agents associated with OA. This method could be included in the clinical evaluation of OA in order to decrease the probability of misdiagnosis.

The main objective of the thesis called: "Benefits of professional practice for graduates in subject of Public Health Protection at Faculty of Health and Social Studies of University of South Bohemia", was to monitor graduates´ views of quality and benefits of professional practice in this field. As a partial objective I decided to find out whether the practice experience met the expectations of graduates. I set three research hypotheses. The first hypothesis says, the graduates in subject of Public Health Protection rate professional practice as beneficial. The second hypothesis says, the graduates in subject of Public Health Protection rate the professional practice as good. The third and last research hypothesis says, the professional practice met the graduates? expectations. First two hypotheses were fully proved, the third hypothesis was proved only from 50%. My thesis is divided into the theoretical and practical part. The chapter "Current State" was worked out by the method of secondary data analysis. I tried to summarize different fields and issues and to explain concepts related to the study and practice of students. The quantitative method was applied to process empirical research. The method of a questionnaire was applied to gather data. The questionnaire was compiled only for the purpose of this research and has 45 questions. There are closed, open and semi-closed questions in the questionnaire. The research sample consists of graduates in subject of Public Health Protection at Faculty of Health and Social Studies in České Budějovice. The data were gathered from November 2010 till March 2011. Survey was voluntary and anonymous. The questionnaires were distributed to 125 graduates in Public Health Protection via the Internet. The resulting research file consists of 72 respondents (100%). Until now, no literature that would examine this issue has been published. Therefore, the findings are unlikely to confront. This thesis might be a valuable feedback providing matter-of-fact and specific comments of graduates. I hope, this research will be inspiration for improvement of both professional practice and tuition.