title: Occupational asthma related to low levels of airborne methylene diphenyl diisocyanate (MDI) in orthopedic casting work.
abstract: Orthopedic plaster casts contain methylene diphenyl diisocyanate (MDI). A few case reports have suggested occupational asthma to MDI in casting work. However, the knowledge of the exposure levels related to the occupational asthma cases is lacking. We report on two occupational asthma cases due to MDI in nurses irregularly applying orthopedic plaster casts, verified with placebo controlled specific inhalation challenge. The levels of MDI in the air were measured in the exposure chamber during the specific inhalation challenges with a quantitative method including filter collection and subsequent liquid chromatography-mass spectrometry (LC-MS) analysis of the isocyanate groups. In order to estimate the level of airborne MDI in casting work, measurements were conducted also in two hospitals during the application and removal of synthetic plaster casts using the same method. The concentrations were well below the occupational exposure limit in both specific inhalation challenge and hospital measurements. Based on our findings, even minor exposure to airborne MDI in casting work can cause an asthmatic reaction in some patients.
authors: Control of Hypersensitivity Diseases Team, Finnish Institute of Occupational Health, Helsinki, Finland. hille.suojalehto@ttl.fi
authors: Hille
authors: H
authors: Suojalehto
authors: Irmeli
authors: I
authors: Linström
authors: Maj-Len
authors: ML
authors: Henriks-Eckerman
authors: Soile
authors: S
authors: Jungewelter
authors: Katri
authors: K
authors: Suuronen
mesh_terms: D000328:Adult; D059366:Asthma, Occupational / Q000139:chemically induced*; D002370:Casts, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D017953:Isocyanates / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects*; D009983:Orthopedic Equipment / Q000009:adverse effects*; D012307:Risk Factors; D001559:Benzhydryl Compounds
chemical_list: D017953:Isocyanates; C005969:4,4'-diphenylmethane diisocyanate; D001559:Benzhydryl Compounds