甲苯二异氰酸酯所致职业性哮喘的风险：综述与风险评估。
Occupational asthma risk from exposures to toluene diisocyanate: A review and risk assessment.
机构信息
National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio.
出版信息
Am J Ind Med. 2018 Apr;61(4):282-292. doi: 10.1002/ajim.22815. Epub 2018 Feb 1.
Abstract
BACKGROUND
Toluene Diisocyanate (TDI) is a known respiratory sensitizer linked to occupational asthma (OA). To better manage worker risks, an appropriate characterization of the TDI-OA dose-risk relationship is needed.
METHODS
The literature was reviewed for data suitable for dose-response modeling. Previous study data were fit to models to derive prospective occupational exposure limits (OELs), using benchmark dose (BMD) and low-dose extrapolation approaches.
RESULTS
Data on eight TDI-exposed populations were suitable for analysis. There were 118 OA cases in a population contributing 13 590 person-years. The BMD-based OEL was 0.4 ppb. The OEL based on low-dose extrapolation to working lifetime extra risk of 1/1000 was 0.3 ppb.
CONCLUSIONS
This study synthesized epidemiologic data to characterize the TDI-OA dose-risk relationship. This approach yielded prospective OEL estimates below recent recommendations by the American Conference of Governmental Industrial Hygienists, but given significant study limitations, this should be interpreted with caution. Confirmatory research is needed.
摘要
背景
甲苯二异氰酸酯（TDI）是一种已知的呼吸道致敏物，与职业性哮喘（OA）有关。为了更好地管理工人的风险，需要对 TDI-OA 的剂量-风险关系进行适当的描述。
方法
对文献进行了回顾，以寻找适合剂量反应建模的数据。使用基准剂量（BMD）和低剂量外推方法，对先前的研究数据进行拟合，以得出预期的职业接触限值（OEL）。
结果
有 8 个人群接触 TDI 的的数据适合分析。在一个贡献了 13590 人年的人群中，有 118 例 OA 病例。基于 BMD 的 OEL 为 0.4 ppb。基于低剂量外推至工作寿命额外风险为 1/1000 的 OEL 为 0.3 ppb。
结论
本研究综合了流行病学数据，以描述 TDI-OA 的剂量-风险关系。这种方法得出的前瞻性 OEL 估计值低于美国政府工业卫生学家会议最近的建议，但鉴于研究存在重大局限性，应谨慎解读。需要进行确证性研究。
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