title: Occupational asthma after exposure to plaster casts containing methylene diphenyl diisocyanate.
abstract: BACKGROUND
  The case of a 34-year-old female nurse is presented. She worked in an accident and emergency department in a district general hospital, with methylene diphenyl diisocyanate (MDI)-containing synthetic plaster casts. She worked with MDI on a daily basis for 4 years. She was out of the department for 1 year and on her return developed cough, wheeze and dyspnoea within 5 min of exposure to MDI- containing synthetic casts.
  
  
  METHODS
  A bronchial provocation test was performed and confirmed an early asthmatic response.
  
  
  RESULTS
  There was a 39% decrease in the forced expiratory volume in 1 s 15 min after exposure, which required the administration of a bronchodilator on two occasions. The patient has subsequently avoided MDI-containing synthetic plaster casts and has experienced no further respiratory symptoms.
  
  
  CONCLUSIONS
  This case illustrates that respiratory sensitization can occur as a result of exposure to MDI-containing synthetic casts and highlights the need for vigilance when health care workers are using isocyanate-containing synthetic casts.
authors.affiliation: Regional Respiratory Centre, Belfast City Hospital, Belfast BT9 7BL, Northern Ireland, UK. r.donnelly2@ntlworld.uk
authors.forename: R
authors.initials: R
authors.lastname: Donnelly
authors.forename: J B
authors.initials: JB
authors.lastname: Buick
authors.forename: J
authors.initials: J
authors.lastname: Macmahon
mesh_terms: D000328:Adult; D000485:Allergens / Q000633:toxicity*; D001249:Asthma / Q000139:chemically induced* / Q000503:physiopathology; D002370:Casts, Surgical / Q000009:adverse effects; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D017953:Isocyanates / Q000633:toxicity*; D009729:Nursing; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects; D001559:Benzhydryl Compounds
chemical_list: D000485:Allergens; D017953:Isocyanates; C005969:4,4'-diphenylmethane diisocyanate; D001559:Benzhydryl Compounds