Environmental Isocyanate-Induced Asthma: Morphologic and Pathogenetic Aspects of an Increasing Occupational Disease

Abstract

Occupational diseases affect more and more people every year. According to the International Labour Organization (ILO), in 2000 an estimated amount of at least 160 million people became ill as a result of occupational-related hazards or injuries. Globally, occupational deaths, diseases and injuries account for an estimated loss of 4% of the Gross Domestic Product. Important substances that are related to occupational diseases are isocyanates and their products. These substances, which are used in a lot of different industrial processes, are not only toxic and irritant, but also allergenic. Although the exposure to higher concentrations could be monitored and restricted by technical means, very low concentrations are difficult to monitor and may, over time, lead to allergic reactions in some workers, ending in an occupational disease. In order to prevent the people from sickening, the mechanisms underlying the disease, by patho-physiological and genetical means, have to be known and understood so that high risk groups and early signs in the development of an allergic reaction could be detected before the exposure to isocyanates leads to an occupational disease. Therefore, this paper reviews the so far known facts concerning the patho-physiologic appearance and mechanisms of isocyanate-associated toxic reactions and possible genetic involvement that might trigger the allergic reactions.

Mass spectrometric identification of isocyanate-induced modifications of keratins in human skin

“…This highly toxic chemical accidentally escaped from a chemical plant during the Bhopal disaster in 1984, resulting in thousands of (fatal) casualties [1,2]. Occupational exposure to isocyanates is known to be an important cause of asthma [3]. In addition, alleged health problems after exposure to di-isocyanates like toluene di-isocyanate (TDI) and methylene diphenyl di-isocyanate (MDI) after application of home insulation have also received much attention [4,5].…”

The role of isocyanates in fire toxicity

“…Most isocyanates can be absorbed into the body by inhalation, ingestion and through the skin, although the main exposure route is inhalation of isocyanate vapours or aerosols (Pronk 2007;Pronk 2006;Hulst et al 2015;Fisseler-Eckhoff et al 2011). In fire effluents, isocyanates are classified as an organic irritant gas, i.e.…”

Effects of MBL2 polymorphisms in patients with diisocyanate-induced occupational asthma

“…1 Toluene DI, 4,4-methylenediphenyl DI and hexamethylene DI are DIs that constitute a group of low-molecular weight agents used in various manufacturing industries, such as painting, construction and wood-working. 2,3 In particular, toluene DI is the most common cause of OA in Korea with a prevalence of 2.9-13% among exposed workers. 4,5 DI-induced OA (DI-OA) is characterized by chronic airway inflammation with remodeling and hyperresponsiveness.…”