Am. J. Respir. Crit. Care Med., Volume 162, Number 2, August 2000, 516-522

Long-term Follow-up of Hexamethylene Diisocyanate-, Diphenylmethane Diisocyanate-, and Toluene Diisocyanate-induced Asthma

PÄIVI L. PIIRILÄ, HENRIK NORDMAN, HELENA M. KESKINEN, RITVA LUUKKONEN, SUVI-PÄIVIKKI SALO, TIMO O. TUOMI, and MATTI TUPPURAINEN

Finnish Institute of Occupational Health and Helsinki University Hospital, Helsinki, Finland

In 1976-1992 245 new cases of asthma induced by diisocyanates were diagnosed, caused by hexamethylene diisocyanate (HDI) in 39%, diphenylmethane diisocyanate (MDI) in 39%, and toluene diisocyanate (TDI) in 17% of the cases. Our aim was to study the clinical outcome of diisocyanate-induced asthma. A questionnaire was sent to the 235 patients alive in 1995, and validated by reexamining clinically 91 of them. The study was carried out on average 10 () yr after the diagnosis. Of the patients 82% experienced symptoms of asthma, 34% used no medication, and 35% were on regular medication. The patients having displayed immunoglobulin E (IgE) antibodies to isocyanates used less medication (OR 0.273; CI 0.098, 0.758) and had fewer symptoms of asthma (OR 0.329; CI 0.124, 0.875) than the IgE-negative ones. They also had a significantly shorter duration of symptoms (p = 0.0025), latency period (p = 0.0249), and duration of exposure (p = 0.0008) than the IgE-negative patients. This did not, however, entirely explain the more favourable outcome of the IgE-positive patients. Patients with HDI-induced asthma used less medication (OR 0.412; CI 0.229, 0.739) than patients with MDI- and TDI-induced asthma. The results confirm the generally rather poor medical outcome of diisocyanate-induced asthma; the persistence of symptoms and unspecific bronchial reactivity were pronounced in TDI-induced asthma. A more favourable outcome was associated with IgE mediation and HDI inducement.

This article has been cited by other articles:

				L. Todd, S. T. Puangthongthub, K. Mottus, G. Mihlan, and S. Wing Health Survey of Workers Exposed to Mixed Solvent and Ergonomic Hazards in Footwear and Equipment Factory Workers in Thailand Ann. Hyg., April 1, 2008; 52(3): 195 - 205. [Abstract] [Full Text] [PDF]

				K. Suuronen, K. Aalto-Korte, R. Piipari, T. Tuomi, and R. Jolanki Occupational dermatitis and allergic respiratory diseases in Finnish metalworking machinists Occup. Med., June 1, 2007; 57(4): 277 - 283. [Abstract] [Full Text] [PDF]

				T. Hannu, K. Alanko, and H. Keskinen Anaphylaxis and allergic contact urticaria from occupational airborne exposure to HBTU Occup. Med., September 1, 2006; 56(6): 430 - 433. [Abstract] [Full Text] [PDF]

				W Anees, V C Moore, and P S Burge FEV1 decline in occupational asthma Thorax, September 1, 2006; 61(9): 751 - 755. [Abstract] [Full Text] [PDF]

				G. Piligian, J. Szeinuk, S. Levin, J. Moline, D. Milek, A. Afilaka, and E. Wilk-Rivard Nonspecific Triggers Also Provoke Occupational Asthma Am. J. Respir. Crit. Care Med., February 1, 2006; 173(3): 357 - 357. [Full Text] [PDF]

				C. E. Mapp, P. Boschetto, P. Maestrelli, and L. M. Fabbri Occupational Asthma Am. J. Respir. Crit. Care Med., August 1, 2005; 172(3): 280 - 305. [Abstract] [Full Text] [PDF]

				P J Nicholson, P Cullinan, A J Newman Taylor, P S Burge, and C Boyle Evidence based guidelines for the prevention, identification, and management of occupational asthma Occup. Environ. Med., May 1, 2005; 62(5): 290 - 299. [Abstract] [Full Text] [PDF]

				O. Vandenplas, K. Toren, and P.D. Blanc Health and socioeconomic impact of work-related asthma Eur. Respir. J., October 1, 2003; 22(4): 689 - 697. [Abstract] [Full Text] [PDF]

				J. Sastre, O. Vandenplas, and H-S. Park Pathogenesis of occupational asthma Eur. Respir. J., August 1, 2003; 22(2): 364 - 373. [Abstract] [Full Text] [PDF]

				M. Padoan, V. Pozzato, M. Simoni, L. Zedda, G. Milan, I. Bononi, C. Piola, P. Maestrelli, P. Boschetto, and C.E. Mapp Long-term follow-up of toluene diisocyanate-induced asthma Eur. Respir. J., April 1, 2003; 21(4): 637 - 640. [Abstract] [Full Text] [PDF]

				A. Karjalainen, R. Martikainen, T. Klaukka, K. Saarinen, and J. Uitti Risk of Asthma Among Finnish Patients With Occupational Rhinitis Chest, January 1, 2003; 123(1): 283 - 288. [Abstract] [Full Text] [PDF]

				R. Piipari, P. Piirila, H. Keskinen, M. Tuppurainen, A. Sovijarvi, and H. Nordman Exhaled nitric oxide in specific challenge tests to assess occupational asthma Eur. Respir. J., December 1, 2002; 20(6): 1532 - 1537. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Asthma, Airway Biology, and Allergic Rhinitis in AJRCCM 2000 Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1559 - 1580. [Full Text] [PDF]