title: Occupational asthma caused by triglycidyl isocyanurate (TGIC).
abstract: BACKGROUND
  Polyester powder paints are extensively used in metal painting. Triglycidyl isocyanurate (TGIC), an epoxy compound, is often used as a hardener. Several cases of allergic eczema from occupational exposure to TGIC have been reported in the literature.
  
  
  OBJECTIVE
  We examined a 36-year-old non-smoking man who worked mainly as a spray painter, using a polyester powder paint containing 4% TGIC. During painting he used protective clothing and a motorized breathing protector. After 4 years he developed eczema on his hands, face and body, and an occupational allergic eczema caused by TGIC was diagnosed. He also suffered from powder-paint-related asthmatic symptoms.
  
  
  METHODS
  Occupational asthma was diagnosed in accordance with the accepted guidelines. Inhalation challenge tests were performed with the paint and TGIC.
  
  
  RESULTS
  Spirometry showed slight obstruction; the blood eosinophils and serum IgE value were elevated. Skin-prick tests with common environmental allergens were negative. The challenge test with lactose powder was also negative. A challenge test with a paint containing TGIC (4%) induced a dual reaction in PEF and a late 23% fall in FEV1. A test with TGIC (4%) mixed with lactose induced a dual PEF reaction, and also dual changes in spirometry. The PD15 in the histamine challenge test decreased significantly after the challenge tests.
  
  
  CONCLUSIONS
  To our knowledge this is the first diagnosed case of occupational asthma caused by TGIC. This case report emphasizes the importance of protecting both the skin and respiratory tract of workers against chemicals such as TGIC, capable of causing skin and respiratory allergy.
authors.affiliation: Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Piirilä
authors.forename: T
authors.initials: T
authors.lastname: Estlander
authors.forename: H
authors.initials: H
authors.lastname: Keskinen
authors.forename: R
authors.initials: R
authors.lastname: Jolanki
authors.forename: A
authors.initials: A
authors.lastname: Laakkonen
authors.forename: P
authors.initials: P
authors.lastname: Pfäffli
authors.forename: O
authors.initials: O
authors.lastname: Tupasela
authors.forename: M
authors.initials: M
authors.lastname: Tuppurainen
authors.forename: H
authors.initials: H
authors.lastname: Nordman
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis*; D001985:Bronchial Provocation Tests; D004485:Eczema / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis; D004802:Eosinophilia; D006632:Histamine / Q000494:pharmacology; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis / Q000276:immunology; D008297:Male; D015394:Molecular Structure; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D012882:Skin Tests; D013147:Spirometry; D014227:Triazines / Q000009:adverse effects* / Q000276:immunology* / Q000494:pharmacology
chemical_list: D014227:Triazines; D007073:Immunoglobulin E; C028786:teroxirone; D006632:Histamine