Asthma in an auto body shop worker: a case study

Details

• Personal Author:
  Beckett WS ; Pechter E
• Description:
  In this issue, we provide a case study of an auto body shop worker exposed to isocyanates. The case study, previously presented by Dr. William Beckett and the American Thoracic Society(1), describes a classic case of occupational asthma (OA). Following the case description are questions posed to highlight some of the key issues related to diagnosis of work-related asthma. Since 1992, the Occupational Health Surveillance Program (OHSP) has received reports of 24 cases of asthma related to isocyanate exposure. Remember to report suspected and confirmed cases of work-related asthma to OHSP by phone, fax or mail. A 24-year-old male auto body shop worker presents with a 4-year history of slowly progressive respiratory complaints which include chest tightness, wheeze, cough productive of minimal white phlegm, and dyspnea. Over the last 4 months, the patient has awakened from sleep twice weekly. His use of albuterol metered dose inhaler has gradually increased to a current level of 10-12 puffs daily. The past medical history is unremarkable, with no history of childhood asthma. He is a smoker with no history of substance abuse. He started working in the auto body shop roughly 4½ years ago, at which time he was symptom-free. Detailed occupational history, including review of Material Safety Data Sheets (MSDS), suggests the use of polyurethane (two-component, hexamethylene diisocyanate or HDI) spray paints. No seasonal symptoms or home precipitants are reported. The physical examination suggests a normal oropharynx and prolonged expiratory phase on chest auscultation. His prebronchodilator spirometry was within normal limits according to ATS criteria. His methacholine challenge test confirmed hyper-reactive airways. He was asked to maintain a record of his peak expiratory flow rates at least four times daily for 2 weeks, both on and off work. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Automobiles Case Reports Diagnosis Isocyanates Lung Lung Diseases Methacholine Compounds Occupational Diseases Occupational Exposure Occupational Health Paint Polyurethanes Respiratory System Respiratory Tract Diseases Safety Smokers Surveys And Questionnaires Tobacco Products Workplace

  More +
• Keywords:
  Airway-resistance Automobile-repair-shops Bronchial-asthma Case-studies Cigarette-smoking Diagnostic-techniques Employee-exposure Health-care Lung-disease Lung-irritants Mechanics Methacholines Occupational-diseases Occupational-exposure Occupational-health Occupational-respiratory-disease Polyurethane-foams Pulmonary-system-disorders Questionnaires Respiratory-system-disorders Smoking Spray-painting Surveillance-programs Work-environment

  More +
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Case Studies
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-2
• NIOSHTIC Number:
  nn:20042678
• Citation:
  SENSOR Occup Lung Dis Bull 2005 Jan; :1-2
• Contact Point Address:
  Massachusetts Department of Public Health, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108
• CAS Registry Number:
  Hexamethylene diisocyanate (CAS RN 822-06-0)
• Federal Fiscal Year:
  2005
• Performing Organization:
  Massachusetts State Department of Public Health
• Peer Reviewed:
  False
• Start Date:
  19880415
• Source Full Name:
  SENSOR Occupational Lung Disease Bulletin
• End Date:
  20050929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2e21ee07e436700e4239d953996ab267731328db4aba4f2a1449ca871c887ace051dc2ea3adc0ca65efeeedbb01d9c25e316397e1c326f13f506312d4b46a12e
• Download URL:
  https://stacks.cdc.gov/view/cdc/194826/cdc_194826_DS1.pdf
• File Type:
  [PDF - 319.54 KB ]