Symptom onset in the first two years of employment at a wood products plant: some observations relevant to occupational medical screening.
Am J Respir Crit Care Med 2001 Apr; 163(5)(2)(Suppl):A810
Medical monitoring during work with sensitizers has been recommended, to facilitate early detection of health effects at a point when prompt control of exposures can reduce long term health consequences. A two-year prospective study was performed among workers at a newly established wood products plant which utilizes a liquid mixture of methylene diphenyl diisocyanate (MDI) and MDI pre polymers. An initial health survey was completed by 214 employees, while 178 participated in semiannual follow-up health surveys, and 144 completed an occupational history. Associations between exposures and the development of specific symptoms were investigated using univariate and multivariate logistic regression analysis methods. Fornoctumal dyspnea, chest tightness (TC), and attacks of dyspnea with wheeze (ATK), onset during the first 2 years was associated (p < 0.01) with job activities involving liquid MDI but not current tobacco smoking, while cough onset was correlated (p < 0.01) with smoking and dusty job activities. New phlegm production was increased with either a dusty job or work with liquid MDI. Among employees working with liquid MDI, onset of A TK & TC tended to occur earlier in employment than other symptoms. Work-related spirometry changes (AFEV1 >10%) were more prevalent among those with symptom onset (p < 0.01). The data suggest that responses to certain questionnaire items may have potential utility in occupational medical screening programs, as early indicators of sensitizing exposures.
Sensitivity-testing; Sensitization; Medical-screening; Occupational-health-programs; Screening-programs; Exposure-assessment; Exposure-levels
American Journal of Respiratory and Critical Care Medicine. Abstracts of the American Thoracic Society 2001 International Conference, May 18-23, 2001, San Francisco, California