Isocyanates and work‐related asthma: Findings from California, Massachusetts, Michigan, and New Jersey, 1993–2008

Abstract

Background Isocyanates remain a leading cause of work-related asthma (WRA). Methods Two independent data systems were analyzed for the period 1993–2008: (1) State-based WRA case surveillance data on persons with isocyanate-induced WRA from four states, and (2) Occupational Safety and Health Administration (OSHA) Integrated Management Information System (IMIS) isocyanate air sampling results. Results We identified 368 cases of isocyanate-induced WRA from 32 industries and 678 OSHA isocyanate air samples with detectable levels from 31 industries. Seventeen industries were unique to one or the other dataset. Conclusion Isocyanate-induced WRA continues to occur in a wide variety of industries. Two data systems uncovered industries with isocyanate exposures and/or illness. Improved control measures and standards, including medical surveillance, are needed. More emphasis is needed on task-specific guidance, spill clean-up procedures, skin and respiratory protection, and targeted medical monitoring to mitigate the hazards of isocyanate use.

Adverse clinical events reported during Invisalign treatment: Analysis of the MAUDE database

“…13 Health effects of isocyanate have been well documented in the literature, including but not limited to increased risk of asthma and contact dermatitis. [14][15][16][17] In an in-vitro cytotoxicity study, oral epithelial cells exposed to Invisalign aligners eluate showed increased cell death, compromised membrane integrity, and reduced cell-to-cell contact and mobility, which may be the mechanism for isocyanate allergy. 8 Forty-five MDRs reported a serious or lifethreatening event (per treating doctor).…”

Use of population data for assessing trends in work-related asthma mortality

“…Identification of such patients triggers a follow-up investigation, which includes evaluating worksite factors potentially responsible for asthma and screening other workers for asthma at the implicated worksite. Despite multiple limitations, these systems offer a unique opportunity to identify work-related asthma cases and related exposures [27,29]. Surveillance in the state of Michigan during 1988-2015 yielded 3417 work-related asthma cases.…”

Autotaxin signaling, purinergic receptors and lung damage

“…We show that nano-molar concentrations of toluene diisocyanate (TDI) [9] , a notorious lung toxicant and respiratory sensitizer [10] , induce a sudden release of ATX from lung epithelial cells and we couple ATX to TDI toxicity [9] .…”

“…So the margin of safety is slim or absent for at least the ceiling value. Of further interest is that it has been claimed that current OELs in USA do not sufficiently protect workers as several cases of diisocyanate asthma were reported in recent years [10] . US OELs are higher than the Swedish OELs [10] so our data support this conclusion.…”

“…Diisocyanates are respiratory sensitizers and contact skin sensitizers, but the mechanisms leading to these effects are not adequately characterized [10,24] . It has been suggested that protein cross-linking might lead to conformational changes in cross-linked proteins and the formation of newly exposed epitopes that provoke immune reactions [13] .…”