Gannon Paul F G, Berg A S, Gayosso R, Henderson B, Sax S E, Willems H M J
Occup Med (Lond). 2005 Dec;55(8):600-5. doi: 10.1093/occmed/kqi184.
Isocyanates are widely used in the manufacture of polyurethane foams, plastics, coatings and adhesives, and are known to cause occupational asthma in a proportion of exposed workers. Substitution as a prevention strategy is not currently a feasible option. For this reason, health and safety professionals working together in an automotive coatings business created a proactive global programme to address the known potential effects of isocyanates on its workers. The goals of the programme are prevention, early detection and mitigation of effect of key endpoints, especially asthma and to a lesser degree dermatitis, in people who are occupationally exposed, or potentially exposed, to isocyanates and products containing isocyanates. The surveillance programme for isocyanates has several important components, which include assessment of exposure, pre-placement questionnaire and spirometry, training and education of employees, regularly administered periodic questionnaires, medical assessment for abnormal questionnaire responses, process for early reporting and investigation of symptomatic employees and incidents, group data review and management reporting. Although regional differences exist regarding availability of specialized services, we have successfully implemented this programme in parts of North America, Europe and Latin America, and are currently implementing elsewhere. These simple control measures are relatively inexpensive and can be applied in even small business settings. It is recommended that all employers who manufacture, handle or use isocyanate-containing products consider such a strategy.
异氰酸酯广泛应用于聚氨酯泡沫、塑料、涂料和粘合剂的制造中，已知会使一部分接触工人患上职业性哮喘。目前，作为一种预防策略，替代方法并不可行。因此，一家汽车涂料企业的健康与安全专业人员共同制定了一项积极的全球计划，以应对异氰酸酯对工人已知的潜在影响。该计划的目标是预防、早期发现并减轻职业接触或潜在接触异氰酸酯及含异氰酸酯产品的人员的关键终点效应，尤其是哮喘，以及程度较轻的皮炎。异氰酸酯监测计划有几个重要组成部分，包括接触评估、上岗前问卷调查和肺活量测定、员工培训与教育、定期发放的定期问卷、对问卷异常回复的医学评估、有症状员工及事件的早期报告和调查流程、群体数据审查以及管理报告。尽管在专业服务的可获得性方面存在地区差异，但我们已在北美、欧洲和拉丁美洲的部分地区成功实施了该计划，目前正在其他地区推行。这些简单的控制措施成本相对较低，甚至可应用于小型企业环境。建议所有制造、处理或使用含异氰酸酯产品的雇主考虑采用这样的策略。
