Medical Education, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Immunology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
BMJ Case Rep. 2023 Jul 11;16(7):e254803. doi: 10.1136/bcr-2023-254803.
Our case describes a hospital worker who suffered a severe reaction to personal protective equipment (PPE) during the COVID-19 pandemic. After researching the excipient list of her PPE and completing a literature review, we postulated that isocyanates used in the production of the polyurethane band of the N95 mask was the cause for her reaction. In the absence of standardised testing, we tested this hypothesis by replicating her reaction to PPE by using a commercially available isocyanate patch, identifying diphenylmethane-4, 4-diisocyanate as the culprit agent.We recommended caution in the use of polyurethane containing N95 masks- for people reporting allergic reaction- and testing for sensitivity for polyurethane. The patient was able to tolerate non-polyurethane containing standard surgical masks, providing an option for PPE in some clinical circumstances. Since avoiding N95 masks, she has not had any further reactions.
我们的病例描述了一名在 COVID-19 大流行期间因个人防护设备 (PPE) 而遭受严重反应的医院工作人员。在研究了她的 PPE 的赋形剂清单并完成文献复习后，我们推测在 N95 口罩的聚氨酯带的生产中使用的异氰酸酯是导致她反应的原因。由于缺乏标准化测试，我们通过使用市售的异氰酸酯贴剂来复制她对 PPE 的反应来验证这一假设，鉴定出二苯甲烷-4,4-二异氰酸酯是罪魁祸首。我们建议对报告过敏反应的人谨慎使用含有聚氨酯的 N95 口罩，并对聚氨酯进行敏感性测试。该患者能够耐受不含聚氨酯的标准手术口罩，为某些临床情况下的 PPE 提供了一种选择。自从避免使用 N95 口罩以来，她没有再出现任何其他反应。
