• 11
    Mar
  • Persistence of Toluene Diisocyanate-Induced Asthma Despite Negligible Workplace Exposures: RESULTS

Job histories within the polyurethane plant for the six asthmatic subjects are reported in Figure 1. The primary occupation in the plant was foam manufac­turing. The retail foam store was approximately one hundred yards from the foam plant. The office building was adjacent to this store. Secretarial employment was on the second floor of a small administrative building attached to the foam production facility. The waste treatment facility was off-site. Finally, the ship­ping supervisor worked on the loading dock in the shipping department but with less direct interaction with manufactured foam than those who loaded trucks and rail cars. At least since 1982, all six asthmatic subjects worked in areas thought to have negligible or no TDI exposure.

None of these six workers had respiratory or asth­matic complaints prior to employment in this work­place. Workers 1, 3, 4 and 5 were never smokers or had not smoked in 15 years. Worker 2 smoked one- half package and worker 6 smoked one-third package of cigarettes daily. No worker changed smoking habits during the four years the questionnaire was adminis­tered. cialis 10 mg

FIGURE 1. This figure reports

FIGURE 1. This figure reports a summary of job histories within the polyurethane foam manufacturing plants for the six asthmatic subjects. The asterisk notes the year of developing respiratory symptoms; the arrow reflects the date of TDI challenge testing; and the X marks the date of job change in the workplace.

Resolution of respiratory complaints did not occur during this time (Table 1). Worker 1 required beta agonist inhalation therapy and theophylline for the first two years and then cromolyn sodium was added to the regimen. Worker 2 required treatment with theophylline and beta agonist inhalers when first tested, but discontinued theophylline in the latter years of the study. Workers 3, 4 and 6 used only a beta agonist inhaler on an as-needed basis during this period. Finally, worker 5, when first evaluated, re¬quired inhaled beclomethasone, beta agonist inhalations and theophylline to control his asthma. Later, the addition of oral prednisone therapy was necessary due to continuing respiratory complaints.

Table 1—Lower Respiratory Symptoms, Upper Respiratory Symptoms, Bronchitis and Dyspnea


Worker

1

2

3

4

5

6

1982

1983

+/-/+/+

1984

NDt

1985

+/+/+/+

Pre- and post-shift lung function tests are reported in Table 2. Three of the six workers had a greater than 15 percent FEV\ decline on one of the days of testing during this five-year period.
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Table 2—Pre- and Post-shift FEVl Values


Worker

1

2

3

4

5

6

1982

113/115

123/111

83/84

82/81


70/ND

118/110

1983

111/109

120/112

84/75

76/75

81/82

109/83$

1984

119/109

110/111

77/76

82/86

ND

101/97

1985

122/119

105/112

83/83

84/81

77/71

110/112

1986

NDt

102/110

86/46$

ND

85/71$

104/109

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