Woellner R C, Hall S, Greaves I, Schoenwetter W F
Internal Medicine Department, Park Nicollet Clinic, HealthSystem Minnesota, Minneapolis 55416, USA.
Am J Ind Med. 1997 Jan;31(1):56-63. doi: 10.1002/(sici)1097-0274(199701)31:1<56::aid-ajim9>3.0.co;2-v.
Eighteen employees with lower respiratory symptoms later confirmed to be occupational asthma were referred for evaluation. All were employees of a single wood products plant using heated methylene diphenyl diisocyanate (MDI) in the manufacture of a synthetic wood product. Of the 18, 15 had no prior airway symptoms or other known bronchial injury, and 16 had positive methacholine bronchial provocation tests. All cases occurred during a 2.5-year period after exposure to a new manufacturing process using steam-heated MDI resin in a new manufacturing facility. Initially, employees developed symptoms related to the start-up process in the plant, with possible higher MDI exposures and probable higher resin temperatures. Later, most employees who developed new symptoms worked in areas of the plant where they were exposed mostly to heated boards. This suggests MDI sensitization arising at lower temperatures than previously considered likely for this substance.
18名出现下呼吸道症状且后来被确诊为职业性哮喘的员工被转诊进行评估。他们均为一家木制品厂的员工，该厂在生产一种合成木制品时使用加热的二苯基甲烷二异氰酸酯（MDI）。这18名员工中，15人此前没有气道症状或其他已知的支气管损伤，16人乙酰甲胆碱支气管激发试验呈阳性。所有病例均发生在新制造设施中采用蒸汽加热MDI树脂的新工艺投入使用后的2.5年期间。起初，员工出现与工厂启动过程相关的症状，可能接触了更高浓度的MDI且树脂温度可能更高。后来，大多数出现新症状的员工在工厂中主要接触加热板材的区域工作。这表明MDI致敏可能在比此前认为该物质可能致敏的温度更低的情况下发生。
