title: Several cases of work-related allergic contact dermatitis caused by isocyanates at a company manufacturing heat exchangers.
abstract: BACKGROUND
  A 43-year-old woman was referred by her occupational health service with suspected occupational contact dermatitis. In connection with the investigation, a workplace visit was undertaken at her company, which used an adhesive based on pre-polymeric diphenylmethane diisocyanate in one of its units. During the visit, we became aware of six other employees with skin problems who were then referred to our department for investigation.
  
  
  OBJECTIVE
  To investigate the seven employees complaining about skin problems.
  
  
  METHODS
  Seven employees were patch tested with a baseline series, an isocyanate series, and a series with work material.
  
  
  RESULTS
  Five of seven patients had occupational contact allergy. Four reacted to isocyanate-related test preparations, and one to a cleanser used at the workplace.
  
  
  CONCLUSIONS
  Workplace visits constitute an important part of an occupational investigation, as they might give a broader picture of the problems at a company. In this case, it was found that 5 of 100 employees currently had or had previously had occupation-related skin problems. Owing to 'healthy worker selection', some of these patients might have been missed if we had not performed a full-scale workplace visit.
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, 205 02 Malmö, Sweden. malin.engfeldt@med.lu.se
authors.forename: Malin
authors.initials: M
authors.lastname: Engfeldt
authors.forename: Marléne
authors.initials: M
authors.lastname: Isaksson
authors.forename: Erik
authors.initials: E
authors.lastname: Zimerson
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
mesh_terms: D000269:Adhesives / Q000633:toxicity*; D000328:Adult; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D005260:Female; D006801:Humans; D017953:Isocyanates / Q000633:toxicity*; D008875:Middle Aged; D009787:Occupational Medicine / Q000379:methods; D010328:Patch Tests; D017132:Workplace; D001559:Benzhydryl Compounds
chemical_list: D000269:Adhesives; D017953:Isocyanates; C005969:4,4'-diphenylmethane diisocyanate; D001559:Benzhydryl Compounds