title: Ocular and airway symptoms related to organic acid anhydride exposure--a prospective study.
abstract: BACKGROUND
  Organic acid anhydrides (OAA) are used as hardeners in epoxy resin systems. They are powerful sensitizers giving frequent rhinitis and asthma in exposed workers. Incidence of symptoms is unknown. Here we present the first prospective study on the associations between OAA exposure, symptoms, and effects of confounding factors.
  
  
  METHODS
  All new employees in three plants handling OAA were followed for up to 8.5 years. Before the employment, a questionnaire reporting about symptoms of eyes and airways, smoking habits, and atopy was answered. The subjects were asked at regular medical examinations about work tasks and work-related symptoms. Serum was analysed for specific OAA antibodies.
  
  
  RESULTS
  Mean exposures varied between 6 and 39 microg/m3. The incidence for work-related symptoms of the eyes, nose, pharynx, and lower airways was 91, 64, 46, and 31 per 1000 years of exposure, respectively. Symptoms were found frequently, even at mean exposure level at <10 microg/m3. Smoking and atopy increased the risk of symptoms. Immunoglobulin (Ig)E sensitized workers had a significant increased risk for symptoms of the eyes and pharynx and for running nose/sneezing.
  
  
  CONCLUSIONS
  Organic acid anhydrides exposure is associated with frequent ocular and airway symptoms even at mean exposure levels at <10 microg/m3. There is an important need for establishment of an occupational threshold limit. A limit value of below 5 microg/m3 is proposed.
authors: Department of Occupational and Environmental Medicine, University Hospital Lund, Lund, Sweden.
authors: J
authors: J
authors: Nielsen
authors: H
authors: H
authors: Welinder
authors: I
authors: I
authors: Bensryd
authors: L
authors: L
authors: Rylander
authors: S
authors: S
authors: Skerfving