Duce F, de Gregorio M A, Pérez J, Portillo J R, Pascual G, Alfonso E R
Servicio de Respiratorio, Hospital Clinico Universitario, Zaragoza, Spain.
Allergol Immunopathol (Madr). 1988 May-Jun;16(3):139-44.
Thirty factory workers whose annual exposure to TDI amounted to 280 hours were examined. Seven of them had been removed from their jobs for presenting respiratory symptomatology and a further five were removed for presenting bronchial asthma. Their medical histories were consulted and further measures were taken such as a radiological thorax study, total IgE, TDI, MDI and HDI RAST, a basal spirometric study and finally a provocation test. The Rast proved negative in every case. In the spirometric study carried out on the provocation test, four cases showed a significant decrease in the FEV1 over 20% and over 40% in the FMEF and PEFR. There was no connection between the four patients who presented an elevated total IgE and the four who presented a positive provocation test. The provocation test proved negative in five of the seven patients removed from their places of work. Two of the four workers who responded positively to the provocation test remained in their places of work during the TDI foam test without showing any symptoms. The patients who presented symptoms did not appear to present bronchial obstruction during the provocation test. Nonetheless, patients who seemingly had not shown any symptoms presented what appeared to be bronchial obstruction.
对30名年接触甲苯二异氰酸酯（TDI）达280小时的工厂工人进行了检查。其中7人因出现呼吸道症状而被调离工作岗位，另有5人因患支气管哮喘被调离。查阅了他们的病史，并采取了进一步措施，如进行胸部放射学检查、检测总免疫球蛋白E（IgE）、TDI、二苯基甲烷二异氰酸酯（MDI）和六亚甲基二异氰酸酯（HDI）放射变应原吸附试验（RAST）、基础肺量计检查，最后进行激发试验。RAST在所有病例中均呈阴性。在激发试验中进行的肺量计检查中，4例患者第一秒用力呼气量（FEV1）显著下降超过20%，最大呼气中期流速（FMEF）和呼气峰值流速（PEFR）下降超过40%。总IgE升高的4例患者与激发试验呈阳性的4例患者之间没有关联。在7名被调离工作岗位的患者中，有5名激发试验呈阴性。在TDI泡沫试验期间，对激发试验呈阳性反应的4名工人中有2名仍留在工作岗位，未出现任何症状。出现症状的患者在激发试验期间似乎没有出现支气管阻塞。然而，看似没有任何症状的患者却出现了疑似支气管阻塞的情况。
