Banks D E, Rando R J
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.
Thorax. 1988 Aug;43(8):660-2. doi: 10.1136/thx.43.8.660.
A worker developed toluene diisocyanate induced asthma in 1974. On reassessment, 11 years after leaving the chemical plant where toluene diisocyanate was produced, he had no respiratory symptoms and normal bronchial reactivity in response to methacholine, and showed no reaction when challenged with a subirritant concentration of toluene diisocyanate. He developed asthma within five months of returning to the workplace. Repeat challenge testing showed bronchial hyperreactivity to methacholine and to the specific sensitising agent, toluene diisocyanate. This clinical pattern could be due to underlying toluene diisocyanate sensitivity with resolution and reappearance of hyperresponsiveness to methacholine and toluene diisocyanate reactivity associated with workplace toluene diisocyanate exposure. Alternatively, this worker may have developed sensitisation to toluene diisocyanate anew.
一名工人于1974年患上了甲苯二异氰酸酯诱发的哮喘。在离开生产甲苯二异氰酸酯的化工厂11年后进行重新评估时，他没有呼吸道症状，对乙酰甲胆碱的支气管反应性正常，并且在受到低于刺激浓度的甲苯二异氰酸酯激发时没有出现反应。他在回到工作场所后的五个月内患上了哮喘。重复激发试验显示对乙酰甲胆碱和特定致敏剂甲苯二异氰酸酯有支气管高反应性。这种临床模式可能是由于潜在的甲苯二异氰酸酯敏感性，伴有对乙酰甲胆碱的高反应性以及与工作场所甲苯二异氰酸酯接触相关的甲苯二异氰酸酯反应性的消退和再现。或者，这名工人可能重新对甲苯二异氰酸酯产生了致敏。
