Occupational asthma (OA) with sensitization to diphenylmethane diisocyanate (MDI) presenting at the onset like a reactive airways dysfunction syndrome (RADS)

Luca Perfetti, Barbara Bramé, Massimo Ferrari, Gianna Moscato

Research output: Contribution to journalArticle

Abstract

Background: Two types of OA are distinguished: immunological (OA with sensitization) and non-immunological, i.e., irritant induced asthma or reactive airways dysfunction syndrome (RADS). Methods: We describe the case of a worker who developed respiratory symptoms after a spill of diphenylmethane diisocyanate (MDI) at the workplace. RADS was initially diagnosed and the worker resumed working. The progressive worsening of symptoms and the appearance of symptoms-work relationship one year later, when concentrations of isocyanates were no longer "irritant," suggested immunological OA. Results: The diagnosis was confirmed by specific inhalation challenge test, followed by removal from exposure and complete recovery. Conclusions: In the case of RADS due to an agent with both irritant and sensitizing properties, history should be repeatedly assessed for a possible symptom-work relationship. If this is found, further investigations should be carried out, including specific inhalation challenges, to confirm the possibility of immunological OA.

Original languageEnglish
Pages (from-to)325-328
Number of pages4
JournalAmerican Journal of Industrial Medicine
Volume44
Issue number3
DOIs
Publication statusPublished - Sep 1 2003

Keywords

  • Asthma
  • Diphenylmethane diisocyanate isocyanates
  • Irritants
  • Occupational asthma
  • Reactive airways dysfunction syndrome
  • Sensitization

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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