Diisocyanates and Work-Related Asthma: Findings from California, Massachusetts, Michigan, and New Jersey, 1993–2008

Details

• Personal Author:
  Davis, Letitia ; Filios, Margaret S. ; Fitzsimmons K ; Flattery J ; Harrison, Robert ; Lefkowitz D ; Lumia, Margaret ; Pechter E ; Reilly MJ ; Rosenman, Kenneth D. ; Stephens A ; Weinberg J
• Description:
  Objective: To characterize work-related asthma (WRA) cases associated with exposure to diisocyanates using data collected from four state-based occupational health surveillance systems. Relevance: WRA is asthma that is caused by or exacerbated by work-related factors. Diisocyanates were first reported to cause WRA in the early 1960s and remain a leading cause of WRA in industrialized countries. From 1978 to 2005, the production of aromatic diisocyanates - toluene diisocyanate (TDI) and methylene bisphenyl diisocyanate (MDI), have more than tripled in the United States. Methods: We reviewed reports of WRA cases associated with exposure to diisocyanates collected from California, Massachusetts, Michigan, and New Jersey during 1993-2008. Association with exposure to diisocyanates was determined using the Association of Occupational and Environmental Clinics (AOEC) exposure codes. WRA was classified as new-onset (i.e., asthma in a person with no prior history of asthma), or work-aggravated asthma (i.e., pre-existing asthma exacerbated by workplace exposures). New-onset cases were further sub-classified as reactive airways dysfunction syndrome (RADS) and as occupational asthma (OA). For each case we examined the 1987 Standard Industrial Classification (SIC) code. Results: A total of 367 cases of WRA were associated with diisocyanate exposure; the mean age was 42.5 years (range: 19-78 years), 224 (61%) were male, 280 (76%) were white, and 295 (80%) were non-Hispanic. Of the 367 WRA cases, 346 (94%) were classified as new-onset asthma, 14 (4%) were classified as work-aggravated asthma; for seven (2%) no information was available to classify. New-onset asthma cases were sub-classified as RADS (n=18, 5%) and as OA (n=328, 95%). Exposure to a specific diisocyanate was known for 195 (53%) cases; the most common diisocyanates reported were MDI (n=87, 22%) and TDI (n=86, 22%). WRA cases were associated with 30 industries. Two industries, Transportation Equipment Manufacturing (SIC 37, 155 cases) and Auto Repair Services (SIC 75, 23 cases) accounted for 48% of the cases. The remaining cases were reported among 28 other industries, including: Sporting and Athletic Goods Manufacturing (SIC 39, 10 cases) where diisocyanates were used in the manufacturing of products such as golf balls; Health Services (SIC 80, 7 cases) where exposures included MDI-containing synthetic orthopedic casting and immobilization cradles; and Textile Mill Products (SIC 22, 2 cases) where diisocyanates were used in the lamination process. Conclusions: In addition to identifying WRA cases in industries where diisocyanate exposure and WRA are known to occur, we identified numerous industries not traditionally associated with diisocyanate exposure. Implications: These findings underscore the need for further preventive actions including education, periodic medical screening by employers, and engineering and industrial hygiene interventions, particularly in those industries not traditionally associated with diisocyanate exposure. [Description provided by NIOSH]
• Subjects:
  Asthma, Occupational Delivery Of Health Care Isocyanates Lung Lung Diseases Occupational Health Race Factors Respiratory System Respiratory Tract Diseases Safety Sex Characteristics

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• Keywords:
  4,4'methylenebisphenyl Isocyanate Diisocyanates Exposure Assessment Gender Factors Lung Disorders MDI Medical Care Occupational Asthma Racial Factors Respiratory Diseases Screening Programs Surveillance Programs

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• Publisher:
  Work Wellness and Disability Prevention Institute (WWDPI)
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  California ; Maryland ; Massachusetts ; Michigan ; New Jersey ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  96
• NIOSHTIC Number:
  nn:20054293
• Citation:
  Isocyanates & Health: Past, Present and Future, April 3-4, 2013, Potomac, Maryland. Vancouver, BC, Canada: Work Wellness and Disability Prevention Institute (WWDPI), 2013 Apr; :96
• Email:
  rosenman@msu.edu
• CAS Registry Number:
  Diphenylmethane diisocyanate (CAS RN 101-68-8) ; Toluene diisocyanate (CAS RN 26471-62-5)
• Federal Fiscal Year:
  2013
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Isocyanates & Health: Past, Present and Future, April 3-4, 2013, Potomac, Maryland
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fe0c048f2e0f4eef2982e281dd753e1ab056561a7f212d0ac20674645cfe6212567ae9d0b9c566d6f376badbda3f110f71da2bfc94e6a519f6eb8063f6b949bb
• Download URL:
  https://stacks.cdc.gov/view/cdc/216887/cdc_216887_DS1.pdf
• File Type:
  [PDF - 705.96 KB ]