title: Different respiratory phenotypes are associated with isocyanate exposure in spray painters.
abstract: Associations have been observed between exposure to isocyanates, consisting mainly of oligomers, and respiratory symptoms and isocyanate specific sensitisation in spray painters. The aim of the present study was to assess associations between isocyanate exposure and more objective respiratory effect measures such as bronchial hyperresponsiveness (BHR), baseline spirometry and exhaled nitric oxide (eNO) in a subset of spray painters. Methacholine challenge and eNO measurements were performed in 229 workers. Questionnaires and blood samples were obtained. Specific immunoglobulin (Ig)E and IgG to hexamethylene di-isocyanate were assessed in serum using various assays. Personal exposure was estimated by combining personal task-based inhalatory exposure measurements and time-activity information. Workers with higher isocyanate exposure were more often hyperresponsive (prevalence ratio comparing the 75th versus 25th percentile of exposure 1.8). In addition, significant exposure-related decreased forced expiratory volume in one second (FEV(1)), FEV(1)/forced vital capacity ratio and flow-volume parameters independent of BHR were found. BHR was more prevalent among sensitised workers. This was statistically significant for only IgG-ImmunoCAP (Phadia, Uppsala, Sweden) positive workers. eNO was not associated with exposure although slightly elevated eNO levels in specific IgG positive subjects were found. The current study provides evidence that exposure to isocyanate oligomers is related to asthma with bronchial hyperresponsiveness as a hallmark, but also shows independent chronic obstructive respiratory effects resulting from isocyanate exposure.
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Pronk
authors.forename: L
authors.initials: L
authors.lastname: Preller
authors.forename: G
authors.initials: G
authors.lastname: Doekes
authors.forename: I M
authors.initials: IM
authors.lastname: Wouters
authors.forename: J
authors.initials: J
authors.lastname: Rooijackers
authors.forename: J-W
authors.initials: JW
authors.lastname: Lammers
authors.forename: D
authors.initials: D
authors.lastname: Heederik
mesh_terms: D000328:Adult; D000336:Aerosols / Q000009:adverse effects*; D016535:Bronchial Hyperreactivity / Q000139:chemically induced / Q000209:etiology*; D001985:Bronchial Provocation Tests; D045853:Exhalation; D005260:Female; D006801:Humans; D017953:Isocyanates / Q000009:adverse effects*; D008168:Lung / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D016273:Occupational Exposure; D010150:Paint / Q000009:adverse effects*; D010641:Phenotype; D013147:Spirometry / Q000379:methods
chemical_list: D000336:Aerosols; D017953:Isocyanates; D009569:Nitric Oxide