Author's response to letters to the editor regarding "risk assessment for toluene diisocyanate and respiratory disease human studies."

Details

• Personal Author:
  Park RM
• Description:
  To the editor, In response to the comments of [letter by Osman-Sypher] the healthy worker survivor effect (HWSE) is now recognized as an important potential source of bias in occupational disease epidemiology. It is particularly troublesome in etiologic studies and when estimating the exposure response relationship in worker populations exposed to irritants or experiencing acute adverse health effects. It occurs when some workers leave employment (or exposure) sooner than others due to health problems but similar effects (such as attenuation of exposure response with increasing cumulative exposure) could result if full ascertainment and recording of exposure-attributable effects depended on exposure levels, if there were development of tolerance, or if personal protective equipment (PPE) had been utilized by some employees but not accounted for in analyses. Toluene diisocyanate (TDI) is just one of numerous reactive entities that occur in composite polymerization systems in manufacturing (e.g., cyanoacrylates, ABS, epoxy resins). The literature reveals complaint-initiated investigations of such materials which subsequently report no apparent association of respiratory problems with duration and other exposure measures at current exposure levels, but without accounting for HWSE or other violations of the assumed model [e.g., Goodman et al.]. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Epidemiology Hypersensitivity Isocyanates Mortality Occupational Health Personal Protective Equipment Respiratory Tract Diseases Safety Toluene

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• Keywords:
  Toluene; Diisocyanates; Sensitization; Etiology; Epidemiology; Asthma; Respiratory system disorders; Mortality rates; Personal protective equipment; PPE
• ISSN:
  2093-7911
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSI - Division of Science Integration
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  131-133
• Volume:
  13
• Issue:
  1
• NIOSHTIC Number:
  nn:20064967
• Citation:
  Saf Health Work 2022 Mar; 13(1):131-133
• Contact Point Address:
  R. M. Park, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), 1090 Tusculum Ave, MS C-15, Cincinnati, OH, 45226-1998, USA
• Email:
  rhp9@cdc.gov
• CAS Registry Number:
  Toluene diisocyanate (CAS RN 26471-62-5)
• Federal Fiscal Year:
  2022
• Peer Reviewed:
  False
• Source Full Name:
  Safety and Health at Work
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4bd8be141fd033e432452668fa87bec49b506dee5e3ccb248c8af0f55625cff8ccc17e53df228092d8c0586a0f074993c86d2a01508080d4fc35561a01c55a98
• Download URL:
  https://stacks.cdc.gov/view/cdc/248625/cdc_248625_DS1.pdf
• File Type:
  [PDF - 194.43 KB ]