Donnelly R, Buick J B, Macmahon J
Regional Respiratory Centre, Belfast City Hospital, Belfast BT9 7BL, Northern Ireland, UK.
Occup Med (Lond). 2004 Sep;54(6):432-4. doi: 10.1093/occmed/kqg133.
The case of a 34-year-old female nurse is presented. She worked in an accident and emergency department in a district general hospital, with methylene diphenyl diisocyanate (MDI)-containing synthetic plaster casts. She worked with MDI on a daily basis for 4 years. She was out of the department for 1 year and on her return developed cough, wheeze and dyspnoea within 5 min of exposure to MDI- containing synthetic casts.
A bronchial provocation test was performed and confirmed an early asthmatic response.
There was a 39% decrease in the forced expiratory volume in 1 s 15 min after exposure, which required the administration of a bronchodilator on two occasions. The patient has subsequently avoided MDI-containing synthetic plaster casts and has experienced no further respiratory symptoms.
This case illustrates that respiratory sensitization can occur as a result of exposure to MDI-containing synthetic casts and highlights the need for vigilance when health care workers are using isocyanate-containing synthetic casts.
本文介绍了一名34岁女性护士的病例。她在一家地区综合医院的急诊科工作，接触含二苯基甲烷二异氰酸酯（MDI）的合成石膏绷带。她每天接触MDI，持续了4年。她离开该科室1年，回来后在接触含MDI的合成石膏绷带5分钟内就出现了咳嗽、喘息和呼吸困难。
进行了支气管激发试验，证实存在早期哮喘反应。
接触后15分钟，第1秒用力呼气量下降了39%，需要两次使用支气管扩张剂。该患者随后避免接触含MDI的合成石膏绷带，未再出现呼吸道症状。
该病例表明，接触含MDI的合成石膏绷带可导致呼吸道致敏，并强调医护人员在使用含异氰酸酯的合成石膏绷带时需要保持警惕。
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