Published ahead of print on July 26, 2007, doi:10.1164/rccm.200702-215OC Am. J. Respir. Crit. Care Med., Volume 176, Number 11, December 2007, 1090-1097 A more recent version of this article appeared on December 1, 2007
Submitted on February 8, 2007 Respiratory Symptoms, Sensitization and Associations with Isocyanate Exposure in Spray PaintersAnjoeka Pronk1,1 Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Business Unit Food and Chemical Risk Analysis, TNO Quality of Life, Zeist, The Netherlands, 2 Business Unit Food and Chemical Risk Analysis, TNO Quality of Life, Zeist, The Netherlands, 3 Research Institute for Occupational Medicine of the Berufsgenossenschaften, Ruhr-University Bochum, Bochum, Germany, 4 Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands, 5 Department of Pulmonary Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands, 6 Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA, 7 Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands * To whom correspondence should be addressed. E-mail: d.heederik{at}iras.uu.nl.
Abstract
Rationale: Associations between oligomeric isocyanate exposure, sensitisation and respiratory disease have received little attention,despite the extensive use of isocyanate oligomers. Objectives: To investigate exposure-response relationships of respiratory symptoms and sensitisation in a large population occupationally exposed to isocyanate oligomers during spray painting. Methods: The prevalence of respiratory symptoms and sensitization was assessed in 581 workers in the spray-painting industry. Personal exposure was estimated by combining personal task-based inhalatory exposure measurements and time activity information. Specific IgE and IgG to hexamethylene diisocyanate (HDI) were assessed in serum by ImmunoCAP assay and enzyme immunoassays using vapor and liquid phase HDI-human serum albumin (HSA) and HSA-conjugates prepared with oligomeric HDI. Measurements and main results: Respiratory symptoms were more prevalent in
exposed than among comparison office workers. Log-linear exposure-response associations were found for asthma-like symptoms, COPD-like symptoms and work-related chest tightness (prevalence ratios for an interquartile range increase in exposure of 1.2, 1.3 and 2.0 respectively, p Key words: oligomer, isocyanate, asthma, spray-painter, sensitization
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0.05). The prevalence of specific IgE sensitization was low (up to 4.2% in spray painters). Nevertheless, IgE to
N100 (oligomeric HDI)-HSA was associated with exposure and work-related chest tightness. The prevalence of specific IgG was higher (2-50.4%) and strongly associated with exposure. Conclusions: The results provide evidence of exposure-response relationships for both work-related and non work-related respiratory symptoms and specific sensitization in a population exposed to oligomers of HDI. Specific IgE was found in only a minority of symptomatic individuals. Specific IgG seems merely an indicator of exposure.
