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Occupational asthma related to low levels of airborne methylene diphenyl diisocyanate (MDI) in orthopedic casting work
Author(s) -
Suojalehto Hille,
Linström Irmeli,
HenriksEckerman MajLen,
Jungewelter Soile,
Suuronen Katri
Publication year - 2011
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.21010
Subject(s) - medicine , occupational asthma , inhalation , occupational exposure limit , asthma , occupational medicine , isocyanate , occupational exposure , plaster casts , orthopedic surgery , surgery , polyurethane , anesthesia , environmental health , composite material , materials science
Orthopedic plaster casts contain methylene diphenyl diisocyanate (MDI). A few case reports have suggested occupational asthma to MDI in casting work. However, the knowledge of the exposure levels related to the occupational asthma cases is lacking. We report on two occupational asthma cases due to MDI in nurses irregularly applying orthopedic plaster casts, verified with placebo controlled specific inhalation challenge. The levels of MDI in the air were measured in the exposure chamber during the specific inhalation challenges with a quantitative method including filter collection and subsequent liquid chromatography‐mass spectrometry (LC‐MS) analysis of the isocyanate groups. In order to estimate the level of airborne MDI in casting work, measurements were conducted also in two hospitals during the application and removal of synthetic plaster casts using the same method. The concentrations were well below the occupational exposure limit in both specific inhalation challenge and hospital measurements. Based on our findings, even minor exposure to airborne MDI in casting work can cause an asthmatic reaction in some patients. Am. J. Ind. Med. 54:906–910, 2011. © 2011 Wiley Periodicals, Inc.