Persistent airways disease caused by toluene diisocyanate.
The natural history of isocyanate-induced asthma is not well documented. We evaluated a patient who developed persistent shortness of breath, wheezing, and cough after a massive exposure to toluene diisocyanate (TDI). Despite no further occupational exposures to isocyanates, he continued to have symptoms of asthma and variable airway obstruction 12 yr later. A methacholine inhalation challenge test was markedly positive, and a bronchial challenge test to TDI produced a dual asthmatic response. This report demonstrates that sensitivity to TDI can persist for many years in the absence of further occupational exposure and suggests that some patients with TDI-induced asthma do not recover from their disease after being removed from isocyanate exposure.
D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D001985:Bronchial Provocation Tests; D003485:Cyanates / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D008688:Methacholine Compounds; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D013997:Time Factors; D014051:Toluene 2,4-Diisocyanate / Q000009:adverse effects*
D003485:Cyanates; D008688:Methacholine Compounds; D016210:Methacholine Chloride; D014051:Toluene 2,4-Diisocyanate