Subclinical immunologic and physiologic responses in hexamethylene diisocyanate-exposed auto body shop workers
Corresponding Author
Carrie A. Redlich MD, MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
YOEMP, 135 College St, New Haven, CT 06511.Search for more papers by this authorMeredith H. Stowe PhD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorAdam V. Wisnewski PhD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorEllen A. Eisen ScD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorMeryl H. Karol PhD
Department of Environmental and Occupational Health, Center for Environmental and Occupational Health and Toxicology, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorRanulfo Lemus PhD
Department of Environmental and Occupational Health, Center for Environmental and Occupational Health and Toxicology, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorCarole T. Holm RN
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorJoyce S. Chung MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorJudy Sparer CIH, MSCE
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorYoucheng Liu ScD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorSusan R. Woskie PhD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorJames Appiah-Pippim MD, MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorRebecca Gore PhD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorMark R. Cullen MD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorCorresponding Author
Carrie A. Redlich MD, MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
YOEMP, 135 College St, New Haven, CT 06511.Search for more papers by this authorMeredith H. Stowe PhD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorAdam V. Wisnewski PhD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorEllen A. Eisen ScD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorMeryl H. Karol PhD
Department of Environmental and Occupational Health, Center for Environmental and Occupational Health and Toxicology, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorRanulfo Lemus PhD
Department of Environmental and Occupational Health, Center for Environmental and Occupational Health and Toxicology, University of Pittsburgh, Pittsburgh, Pennsylvania
Search for more papers by this authorCarole T. Holm RN
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorJoyce S. Chung MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorJudy Sparer CIH, MSCE
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorYoucheng Liu ScD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorSusan R. Woskie PhD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorJames Appiah-Pippim MD, MPH
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorRebecca Gore PhD
Department of Work Environment, University of Massachusetts—Lowell, Lowell, Massachusetts
Search for more papers by this authorMark R. Cullen MD
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510
Search for more papers by this authorAbstract
Background
Diisocyanates are potent sensitizing agents and currently the most commonly identified cause of occupational asthma in industrialized countries. However, diisocyanate asthma is difficult to diagnose and exposure and host risk factors are unclear. Auto body shops, one of the most common hexamethylene diisocyanate (HDI) exposure settings, are particularly difficult to study due to their small size and episodic exposures. Surveillance studies of such workers are limited.
Objectives
We have initiated a cross-sectional field epidemiologic study, Survey of Painters and Repairers of Auto bodies by Yale (SPRAY), to characterize the effects of diisocyanate exposures on actively employed auto body shop workers.
Methods and Results
We present here questionnaire, physiologic, immunologic, and exposure data on 75 subjects enrolled in the study. No overt cases of clinically apparent diisocyanate asthma were identified based on spirometry, methacholine challenge, peak flows, and symptoms. HDI-specific lymphocyte proliferation was present in 30% of HDI-exposed workers and HDI-specific IgG in 34% of HDI-exposed workers, but they were not associated. HDI-specific IgE was detected in two workers. HDI-specific lymphocyte proliferation, increased methacholine responsiveness, and symptoms of chest tightness and shortness of breath were more common in the most heavily HDI-exposed workers, the painters. More long-term follow-up of this cohort should clarify the significance of these HDI-specific immunologic responses, physiologic changes, and symptoms.
Conclusions
These findings demonstrate the presence of HDI-specific immune responses in a large proportion of healthy HDI-exposed workers. Am. J. Ind. Med. 39:587–597, 2001. © 2001 Wiley-Liss, Inc.
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