title: Outcome determinants for isocyanate induced occupational asthma among compensation claimants.
abstract: OBJECTIVE
  To compare the outcome of occupational asthma (OA) induced by isocyanates in Ontario (where a surveillance programme for exposed workers has been in place for over 15 years), with the outcome of OA induced by other work agents.
  
  
  METHODS
  Compensated OA claims during the period 1984-88 in Ontario were retrospectively reviewed in a standardised way.
  
  
  RESULTS
  136/235 compensated claims were attributed to isocyanates. Compared with other causes of OA, those attributed to isocyanates had a shorter latent period before onset (5.9 v 7.9 years, P < 0.05), shorter duration of symptoms before diagnosis (2.0 v 3.0 years, P < 0.05), and less associated atopy (43% v 58%, P < 0.05). Outcome at a mean of 1.9 years after initial assessment was significantly better in those with OA induced by isocyanates; 73% cleared or improved v 56% with other causes of OA (P < 0.05). Ten subjects with OA induced by isocyanates stayed at the same work; none cleared and four had worsened at follow up. A better outcome in OA induced by isocyanates was associated with early diagnosis (P < 0.05), and early removal from isocyanates after the onset of asthma.
  
  
  CONCLUSIONS
  The outcome in the group with OA induced by isocyanates is similar to previous follow up studies. However, it is better than the outcome in our comparison group with OA due to other causes, perhaps because of earlier diagnosis in the group with OA induced by isocyanates. This may be attributable to the medical surveillance of workers exposed to isocyanates in Ontario, either directly from the surveillance assessments, or indirectly by increasing awareness of the condition.
authors.affiliation: Gage Occupational and Environmental Health Unit, University of Toronto, Ontario, Canada.
authors.forename: S M
authors.initials: SM
authors.lastname: Tarlo
authors.forename: D
authors.initials: D
authors.lastname: Banks
authors.forename: G
authors.initials: G
authors.lastname: Liss
authors.forename: I
authors.initials: I
authors.lastname: Broder
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017953:Isocyanates / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D009864:Ontario; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014942:Workers' Compensation
chemical_list: D017953:Isocyanates