Prevention Guidance for Isocyanate-Induced Asthma Using Occupational Surveillance Data

Abstract

Data from Washington State's work-related asthma surveillance system were used to characterize isocyanate-induced asthma cases occurring from 1999 through 2010. Injured worker interviews and medical records were used to describe the industry, job title, work process, workers’ compensation cost, and exposure trends associated with 27 cases of isocyanate-induced asthma. The majority (81%) of cases were classified within the surveillance system as new-onset asthma while 19% were classified as work-aggravated asthma. The workers’ compensation cost for isocyanate-induced asthma cases was $1.7 million; this was 14% of the total claims cost for all claims in the asthma surveillance system. The majority of cases (48%) occurred from paint processes, followed by foam application or foam manufacturing (22%). Nine of the asthma cases associated with spray application occurred during application to large or awkward-shaped objects. Six workers who did not directly handle isocyanates (indirect exposure) developed new-onset asthma. Two cases suggest that skin contact and processes secondary to the isocyanate spray application, such as cleanup, contributed to immune sensitization. Surveillance data provide insight for the prevention of isocyanate-induced respiratory disease. Key observations are made regarding the development of work-related asthma in association with a) paint application on large objects difficult to ventilate, b) indirect exposure to isocyanates, c) exposure during secondary or cleanup processes, and d) reports of dermal exposure.

Biological and environmental exposure monitoring of volatile organic compounds among nail technicians in the Greater Boston area

“…Of particular concern was the listing of polyurethanes as an ingredient in one of the nail polish brands found in the salons studied. Polyurethanes have been well documented as potent sensitizers in the autobody industry . This was particularly concerning, as the nail polish containing polyurethanes was labeled as non‐allergenic.…”

“…Polyurethanes have been well documented as potent sensitizers in the autobody industry. 69 This was particularly concerning, as the nail polish containing polyurethanes was labeled as non-allergenic.…”

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

“…More importantly, isocyanates may not be airborne at consistent levels during all work hours. Isocyanate use may be intermittent (e.g., spill cleanup), product‐specific, related to infrequent maintenance, or exposure may be indirect [Petsonk et al, ; Reeb‐Whitaker et al, ]. In addition, accurate air sampling for isocyanates is difficult, imprecise, and dependent on whether isocyanates are in gas or aerosol form, the size of the particles, the extraction and laboratory analysis methods used and the effectiveness in capturing monomers and polymers [Streicher et al, ; Bello et al, ; Lesage et al, ; Henneken et al, ; Booth et al, ; Thomasen et al, ; Reeb‐Whitaker et al, ; Schaeffer et al, ; Lockey et al, ].…”

Hazardous materials in buildings

“…Similar type of study, Washington State's work-related asthma surveillance system, was reported and has illustrated the exposure risk of workers to isocyanates when spraying foam insulation in buildings which characterized isocyanate-induced asthma cases. 58 For construction, MDI and TDI would be the major isocyanates used in majority of polyurethane products for buildings. Isocyanates could cause irritation to the skins and eyes, mucous membranes, and respiratory system.…”