title: Exposure biomarkers and risk from gluing and heating of polyurethane: a cross sectional study of respiratory symptoms.
abstract: OBJECTIVE
  To define the relation between exposure to polyurethane (PUR) glue, biomarkers of exposure and effect, and work related symptoms that occur at least once a week.
  
  
  METHODS
  In a cross sectional study, 152 workers and 14 clerks in a factory with exposure to sprayed and heated PUR glue containing 4, 4'-diphenylmethane (MDI) or 1,6-hexamethylene (HDI) di-isocyanate were examined with gas chromatography-mass spectrometry (GC-MS) for metabolites of MDI in plasma (P-MDX) and urine (U-MDX), 2,4- and 2, 6-toluene di-isocyanate (TDI; P-TDX, U-TDX) and HDI in plasma and urine, specific serum IgG (S-IgG-MDI, S-IgG-HDI, and S-IgG-TDI, respectively) and IgE (S-IgE-MDI). Work related symptoms of the eyes and airways (nose or lower airways, or both), and lung function were also evaluated.
  
  
  RESULTS
  P-MDX was detected in 65% of the workers, U-TDX in 47%, HDX in none. Three per cent were positive for S-IgE-MDI, 33% for S-IgG-MDI, 32% for S-IgG-TDI, and 12% for S-IgG-HDI. A few clerks had metabolites, and some had antibodies. Most metabolites and immunoglobulins were slightly correlated-for example, P-MDX v S-IgG-MDI: r(s)=0.21. Workers who heated glue had increased P-MDX (odds ratio (OR)=12 for a value above the median) and S-IgG-MDI (OR=3.7), sprayers P-2,4-TDX (OR=6.2) and P-2,6-TDX (OR=16). Twenty six per cent of the workers had work related symptoms of the airways, 21% from the nose, 11% from the lower airways. Spraying of glue increased the risk of work related symptoms and slightly decreased lung function. U-MDX was associated with work related symptoms from the airways (OR=3.7) and P-2,6-TDX with work related symptoms from the lower airways (OR=6.6). S-IgG-MDI was related to work related symptoms from the airways (OR=2.6).
  
  
  CONCLUSIONS
  There were relations between exposures to sprayed and heated PUR glue based on MDI and HDI, concentrations of metabolites of MDI and TDI in plasma and urine, specific IgG serum antibodies against MDI, TDI, and HDI, and work related symptoms.
authors.affiliation: Department of Occupational and Environmental Medicine, University Hospital, S-221 85 Lund, Sweden. margareta.littorin@ymed.lu.se
authors.forename: M
authors.initials: M
authors.lastname: Littorin
authors.forename: L
authors.initials: L
authors.lastname: Rylander
authors.forename: G
authors.initials: G
authors.lastname: Skarping
authors.forename: M
authors.initials: M
authors.lastname: Dalene
authors.forename: H
authors.initials: H
authors.lastname: Welinder
authors.forename: U
authors.initials: U
authors.lastname: Strömberg
authors.forename: S
authors.initials: S
authors.lastname: Skerfving
mesh_terms: D000269:Adhesives / Q000009:adverse effects; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D003485:Cyanates / Q000378:metabolism; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D017953:Isocyanates / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000378:metabolism; D016273:Occupational Exposure / Q000009:adverse effects; D011140:Polyurethanes / Q000009:adverse effects*; D012120:Respiration Disorders / Q000139:chemically induced* / Q000378:metabolism; D018570:Risk Assessment; D001559:Benzhydryl Compounds
chemical_list: D000269:Adhesives; D015415:Biomarkers; D003485:Cyanates; D007074:Immunoglobulin G; D017953:Isocyanates; D011140:Polyurethanes; C015262:1,6-hexamethylene diisocyanate; C005969:4,4'-diphenylmethane diisocyanate; D001559:Benzhydryl Compounds