Vandenplas O, Cartier A, Lesage J, Cloutier Y, Perreault G, Grammer L C, Shaughnessy M A, Malo J L
Department of Chest Medicine, Sacré-Coeur Hospital, Montreal, Canada.
J Allergy Clin Immunol. 1993 Apr;91(4):850-61. doi: 10.1016/0091-6749(93)90342-d.
Occupational asthma (OA) caused by products that contain hexamethylene diisocyanate (HDI) has been ascribed to the highly volatile monomer of HDI. Most two-component paints are now made up primarily of nonvolatile prepolymers of HDI (30% to 60%) with only trace amounts (< 0.1%) of the monomer. The respective role of the two chemical forms of HDI in causing OA has never been investigated.
Twenty workers who were consecutively referred for possible OA that resulted from exposure to spray paints underwent inhalation challenges on separate days with pure HDI monomer and the commercial formulation of HDI prepolymers to which they had been exposed at work.
Specific inhalation challenges elicited a positive asthmatic reaction in 10 of the 20 subjects. Among these subjects, four had positive bronchial reactions (two early, one late, and one dual) to both the monomer and the prepolymers. Four other subjects had asthmatic reactions (two early, one late, and one dual) after exposure to the prepolymers but not after exposure to the monomer. The discordance in bronchial response elicited by the monomer and the prepolymers could not be due to differences in the level of baseline nonspecific bronchial reactivity or in HDI concentrations during the tests. One subject showed an atypical progressive reaction after exposure to the monomer but not after exposure to the prepolymer. In this case, the discordant response could be explained by differences in HDI concentration.
These observations show that, although they are nonvolatile, the prepolymers of HDI can induce OA and that asthmatic reactions as a result of exposure to prepolymers but not the monomer is not a rare occurrence.
由含有六亚甲基二异氰酸酯（HDI）的产品引起的职业性哮喘（OA）被认为是由HDI的高挥发性单体所致。现在大多数双组分涂料主要由HDI的非挥发性预聚物（30%至60%）组成，单体含量仅为痕量（<0.1%）。从未研究过HDI的两种化学形式在引起OA方面各自的作用。
连续有20名因接触喷漆可能患OA而前来就诊的工人，在不同日期分别用纯HDI单体和他们在工作中接触过的HDI预聚物商业配方进行吸入激发试验。
特异性吸入激发试验在20名受试者中的10名引发了阳性哮喘反应。在这些受试者中，4名对单体和预聚物均有阳性支气管反应（2名早期反应、1名晚期反应和1名双相反应）。另外4名受试者在接触预聚物后出现哮喘反应（2名早期反应、1名晚期反应和1名双相反应），但接触单体后未出现。单体和预聚物引发的支气管反应不一致并非由于基线非特异性支气管反应性水平或试验期间HDI浓度的差异。1名受试者在接触单体后出现非典型进行性反应，但接触预聚物后未出现。在这种情况下，反应不一致可由HDI浓度差异来解释。
这些观察结果表明，尽管HDI预聚物是不挥发的，但它可诱发OA，并且接触预聚物而非单体导致的哮喘反应并非罕见。
