Isocyanate sensitization: a cross sectional study of MDI exposure and effects in the production of polyurethane coated fabrics.
Liss-DJ; Lutgendorf-CS; Daly-CM; Stowe-MH; Wisnewski-AV; Gulati-M; Liu-Y; Sparer-J; Redlich-CA
Proc Am Thorac Soc 2005 May; 2(Abstracts):A816
Isocyanates are the most commonly identified cause of occupational asthma, but risk factors, including the role of skin exposure in sensitization, remain poorly defined. Markers of exposure and early disease are greatly needed. To characterize the effects and potential markers of methylene diphenyl diisocyanate (MDI) skin and respiratory exposures, we conducted a cross sectional evaluation of a corporate workforce manufacturing polyurethane coated fabrics. Questionnaire, immunologic and pulmonary physiologic assessments were performed on all 90 employees. Air, skin and surface MDI measurements were also collected. Eight percent of employees had an established asthma diagnosis. MDI-specific IgG was present in 35 of 90 employees (39%) and was strongly associated with MDI exposure, as determined by job title (p<0.01). Among 35 workers with MDI-specific IgG, 30 (86%) worked on production lines, while 0 of 12 office workers had MDI-specific IgG. Those with MDI-IgG did not differ from colleagues in regards to age, race, smoking status, spirometry, asthma or atopy. However, MDI-specific IgG was associated with positive methacholine challenge testing (p=0.03) and with symptoms of cough (p=0.03) and chest tightness (p<0.01). Air sampling for MDI monomer ranged from 0 to 8 ppb, well under OSHA exposure limits. Qualitative dermal MDI exposure was detected on 14 (23%) of the 61 skin wipes collected. MDI-IgG was seen in a substantial proportion of workers and associated strongly with exposure, assessed by job title, and with increased prevalence of airways hyper-responsiveness and asthma symptoms. Low MDI air levels and documented dermal exposures suggest dermal exposure may playa significant role in immune sensitization to MDI.
Isothiocyanates; Sensitization; Fabrics; Occupational-diseases; Diseases; Bronchial-asthma; Risk-factors; Occupational-exposure; Questionnaires; Immunology; Employees; Employee-health; Workers; Worker-health; Air-sampling; Exposure-levels; Exposure-limits
Abstract; Conference/Symposia Proceedings
Issue of Publication
Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the American Thoracic Society. 2005 ATS International Conference, May 20-25, 2005, San Diego, California
Yale University, New Haven, Connecticut