Clinical and immunological evaluation of isocyanate-exposed workers.
Isocyanates are the most significant cause of occupational asthma in our country. To evaluate the prevalence of work-related respiratory symptoms and immunologic sensitization to it, we performed a questionnaire survey, allergy skin test, radioallergosorbent test (RAST) to toluene diisocyanate (TDI)-human serum albumin (HSA) conjugate and methacholine bronchial challenge test on 23 isocyanate-exposed employees and 9 unexposed controls working in a zipper factory. Six employees (26.1%) complained of work-related respiratory symptoms and three symptomatic workers showed significant bronchoconstrictions on TDI-bronchoprovocation test. Three (13%) asymptomatic workers had high specific IgE antibodies to TDI-HSA and none of the TDI-sensitive asthmatic workers had specific IgE antibody. One of the TDI-sensitive asthmatic workers showed a negative result on the initial methacholine bronchial challenge test, but bronchial hyperresponsiveness developed after the TDI challenge. It was suggested that TDI-sensitive asthma was noted in three (13%) of 23 exposed workers and that asymptomatic workers could have high specific IgE antibody. Measurement of the changes in bronchial hyperresponsiveness after the TDI challenge could be helpful to diagnose TDI-sensitive asthma.
Park
H S
HS
Department of Chest Medicine, National Medical Center, Seoul, Korea.
Park
J N
JN
Kim
J W
JW
Kim
S K
SK
D000328:Adult; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D001985:Bronchial Provocation Tests; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D016273:Occupational Exposure; D012709:Serum Albumin / Q000276:immunology; D014051:Toluene 2,4-Diisocyanate / Q000009:adverse effects* / Q000276:immunology
D012709:Serum Albumin; D014051:Toluene 2,4-Diisocyanate; D007073:Immunoglobulin E