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Creating an indoor environmental problem from a nonproblem: a need for cautious evaluation of antibodies against hapten-protein complexes.

Patterson-R; Beltrani-VS; Singal-M; Gorman-RW; Zeiss-CR; Harris-KE
New England and Regional Allergy Proceedings 1985 Jan; 6(2):135-139
An outbreak of illness falsely attributed to indoor exposure to diphenylmethane-diisocyanate (101688) (MDI) was described. An epidemic of illness characterized by eye, nose, and throat irritation, and headache occurred among students and the staff in three schools in Dutchess County, New York in January and February, 1983. MDI emissions from polyurethane insulation that had been installed in the schools in the preceding year was suggested as a cause of the symptoms. The outbreak received widespread press coverage in the local community. Sera from 56 individuals in the school were assayed for immunoglobulin-G (IgG) and immunoglobulin-E (IgE) antibodies against MDI/human serum albumin (HSA). Sera from nine school children in Chicago having no known MDI exposure were analyzed for comparison purposes. Five samples in subjects from the affected schools were positive for IgE and one sample was positive for IgG antibodies. The titers were generally low. None of the Chicago children had IgG antibodies against MDI/HSA. Two had IgE antibodies against MDI/HSA. Sera samples from four additional school children with symptoms suggestive of allergic rhinitis or allergic asthma were also analyzed and were negative for both IgE and IgG. Air sampling conducted by NIOSH found no detectable quantities of MDI, methylene-dianiline (101779), a hydrolysis product of MDI, or aliphatic amines. Only background concentrations of formaldehyde (50000), organic vapors, and metals were found. Boiler exhaust gases were found to be leaking back into the schools by way of draw downs on the chimney. The symptoms at one school persisted after the ventilation deficiencies were corrected. The authors conclude that environmental contamination was probably not the only cause of the outbreak. The outbreak may have been spread by hysteria generated by press coverage and the inappropriate use of IgE and IgG antibody tests that suggested that the schools were contaminated with MDI.
Isocyanates; Epidemiology; Indoor-air-pollution; Air-sampling; Clinical-symptoms; Immunoglobulins; Immunochemistry; Antibody-response; Indoor-environmental-quality
101-68-8; 101-77-9; 50-00-0
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New England and Regional Allergy Proceedings