title: Hypersensitivity pneumonitis-like reaction and occupational asthma associated with 1,3-bis(isocyanatomethyl) cyclohexane pre-polymer.
abstract: Twenty-three of 34 workers who had worked in the injection molding operation making polyurethane foam parts at an automobile parts manufacturing plant developed respiratory symptoms and/or systemic symptoms over a 2-month period following the full production use of a new diisocyanate paint that contained 1,3-bis(isocyanatomethyl)cyclohexane pre-polymer (BIC)(CAS #75138-76-0, 38661-72-2). At 3 months, all subjects underwent an interview, physical examination, pre- and post-shift pulmonary function tests, and either methacholine challenge test or bronchodilator challenge at an occupational health clinic. The most frequently cited symptoms were dyspnea (65%), cough (61%), chest tightness (57%), chills (57%), wheezing (30%), and myalgias, arthralgias, and nausea (26%). Thirteen subjects had either a positive methacholine challenge test or a positive response to bronchodilator challenge, making the overall prevalence of airway hyperresponsiveness 38%. The overall prevalence of hypersensitivity pneumonitis-like reactions among line operators in the injection molding process was 27%. This disease outbreak suggests that 1,3-bis(isocyanatomethyl)cyclohexane pre-polymer may cause asthma and hypersensitivity pneumonitis-like reactions. The use of BIC was discontinued 6 months after the first workers developed symptoms.
authors.affiliation: Department of Environmental and Industrial Health, University of Michigan, School of Public Health, Ann Arbor 48109-2029, USA.
authors.forename: C
authors.initials: C
authors.lastname: Simpson
authors.forename: D
authors.initials: D
authors.lastname: Garabrant
authors.forename: S
authors.initials: S
authors.lastname: Torrey
authors.forename: T
authors.initials: T
authors.lastname: Robins
authors.forename: A
authors.initials: A
authors.lastname: Franzblau
mesh_terms: D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced*; D018771:Arthralgia / Q000139:chemically induced; D001249:Asthma / Q000139:chemically induced*; D001336:Automobiles; D016535:Bronchial Hyperreactivity / Q000139:chemically induced; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents; D002637:Chest Pain / Q000139:chemically induced; D003371:Cough / Q000139:chemically induced; D003510:Cyclohexanes / Q000009:adverse effects*; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D006801:Humans; D017953:Isocyanates / Q000009:adverse effects*; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced; D009325:Nausea / Q000139:chemically induced; D009784:Occupational Diseases / Q000139:chemically induced*; D010150:Paint / Q000009:adverse effects; D011108:Polymers / Q000009:adverse effects*; D015995:Prevalence; D012135:Respiratory Sounds; D012768:Shivering
chemical_list: D001993:Bronchodilator Agents; D003510:Cyclohexanes; D017953:Isocyanates; D011108:Polymers; D016210:Methacholine Chloride; C103285:1,3-bis(isocyanatomethyl)cyclohexane