title: Asthma death after spraying polyurethane truck bedliner.
abstract: BACKGROUND
  Isocyanate exposure is the most common cause of work-related asthma. In 2003, a male in his mid-40s died of an acute asthmatic reaction approximately 1 hr after he sprayed the inside of a cargo van with an isocyanate-containing truck bedliner. This is the first reported death attributable to this type of isocyanate application.
  
  
  METHODS
  The Michigan Fatality Assessment and Control Evaluation (MIFACE) program investigated this work-related fatality to identify the factors that contributed to his death. The investigation included site visits, personal interviews, and a review of pertinent documents.
  
  
  RESULTS
  Factors contributing to his death included: the vehicle type; lack of engineering controls; lack of a company safety and health program, including a personal protective equipment program, medical monitoring, and employee training; and a lack of recognition of work-relatedness of the deceased's respiratory problems by a health care provider.
  
  
  CONCLUSIONS
  This work-related fatality investigation demonstrates the need for isocyanate manufacturers/formulators to inform end users of their products of appropriate health and safety work practices associated with new technologies. In addition, health care providers need more education and assistance to recognize and manage work-related asthma.
authors.affiliation: Department of Occupational and Environmental Medicine, MIFACE, Michigan State University, 117 West Fee Hall, East Lansing, MI 48824-1315, USA. debra.chester@ht.msu.edu
authors.forename: Debra A
authors.initials: DA
authors.lastname: Chester
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hanna
authors.forename: Barton G
authors.initials: BG
authors.lastname: Pickelman
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Rosenman
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced*; D001336:Automobiles; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011140:Polyurethanes / Q000633:toxicity*; D012307:Risk Factors
chemical_list: D011140:Polyurethanes