Exposure to toluenediamines from polyurethane-covered breast implants.

Toluenediamines (TDA) were monitored in blood, urine and redon drainage following implantation of polyurethane (PU)-covered breast prostheses. In the redon drainage TDAs showed an initial steep drop. The levels did not fall below detection limits but formed a plateau, which suggests a continued degradation of the PU foam. Urinary metabolite levels were above pre-operation background in all samples collected. In plasma there is an initial lag period of 20-30 days, where little above background TDA was found, after which levels rose to above 4.0 and 1.5 ng/ml plasma for 2,4-toluenediamine (24TDA) and 2,6-toluenediamine (26TDA), respectively. Elevated levels were found up to 2 years post-operation. Acid hydrolysis of precipitated plasma proteins released equivalent amounts of TDA as from total plasma, TDA being covalently bound to both albumin and globulin fractions. Urinary and plasma levels from these patients are in the same range detected from occupational exposure to toluene diisocyanate.