Annals of Occupational and Environmental Medicine

Original Article

Prevalence of Occupational Asthma in TDI-Exposed Workers: Hyoung Ryoul Kim, Cheol Woo Kim, Yun Chul Hong, Hyung Joon Chun, Chi Nyon Kim, Hyun Soo Kim, Jee Na Lee, Joo Yeon Shin, Dong Hee Koh, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2004;16(2):191-199. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.191

Abstract PDF: OBJECTIVES
This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers.
METHODS
We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests.
RESULTS
Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma, and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1%). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test.
CONCLUSIONS
The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

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Original Article

Characteristics of Occupational Asthma Reported by Surveillance System in Incheon: Hyoung Ryoul Kim, Yun Chul Hong, Jong Han Leem, Jong Uk Won, Hyung Joon Chun, Jee Na Lee, Joo Yeon Shin; Korean Journal of Occupational and Environmental Medicine 2003;15(4):344-350. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.344

OBJECTIVES
This study was carried out to estimate the magnitude of occupational asthma and to determine its characteristics.
METHODS
We collected and analyzed 121 cases of occupational asthma reported by a surveillance system in Incheon for 5 years. The cases were classified according to industry and causing gent. We attached the data to worker's compensation records to establish the degree of agreement between the two sources.
RESULTS
The industry of musical instrument manufacture was the most common (31 cases, 25.6%), followed by furniture manufacture, dye making, and machinery manufacture. TDI was the most common causing agents (52 cases, 43%), followed by reactive dye, wood dust, and organic dust. There was poor agreement with the worker's compensation records (2 cases, 8%).
CONCLUSIONS
TDI and reactive dyes were the major materials causing occupational asthma. Most cases reported by the surveillance system were not applied to the worker's compensation system. Therefore, the surveillance system should be used to estimate the magnitude of occupational asthma and to determine its characteristics.

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Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
Woori Jo, Kwang Won Seo, Hwa Sik Jung, Chui Yong Park, Byung Ju Kang, Hyeon Hui Kang, Seung Won Ra, Yangjin Jegal, Jong Joon Ahn, Soon Eun Park, Moon Sik Jung, Ju Ik Park, Eun Ji Park, Chang Sun Sim, Tae-Bum Kim, Taehoon Lee
Allergy, Asthma & Immunology Research.2021; 13(2): 256. CrossRef
Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef

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Original Article

A Study on Comparison of the Metabolites Related with Working Methods and Immunity of the Toluene diisocyanate-Exposed Workers: Su Ill Lee, Byung Man Cho, In Kyung Hwang, Cheol Ho Lee, Jung Rae Park; Korean Journal of Occupational and Environmental Medicine 1998;10(3):320-332. Published online August 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.3.320

Abstract PDF

Following recent advanced industrialization. the amount of polyurethane to use as thermal insulating materials, upholstery mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents. Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting, abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI-induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell, T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI-exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC. %Lymph (percentile of Lymphocyte in WBC). %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows ; 1. The logarithm of IgE -Log10(IgE)+/-SD- in peripheral blood of a exposed group was significantly higher than a control group, 2 22+/-.62 in case group compared with 1.98+/-.53 in control group.(p<0.05) 2. IgA and IgM in the polyurethane-producing workers were 261.02+/-3.12 mg/dl, 151.97+/-9.64 mg/dl, respectively, and 292.77+/-00.45, 179.17+/-00.78 in control group. IgA and IgM was slightly lower in polyurethane-producing group than control (p>0.05). 3. WBC, %Lymph, %T-cell, C3, C4, CD4, CD8, CD4/CDB ratio and IgG in case group were 6,391.1 ea/ml, 37.53%, 59.54%, 76.68 mg/dl, 30.54 mg/dl, 0.76x10(9) ea/L, 0.63x10(9) ea/L, 1.39, and 1606.29 mg/dl, respectively, and 6,974.7 ea/ml, 35.12%, 59.64%, 71.95 mg/dl, 33.94 mg/dl, 0.80x109 ea/L, 0.61x10(9) ea/L, 1.39, and 1581.51 mg/dl in control group. There was no statistical sinificance between two groups. (p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2,6-TDA which is a metabolite of well-vaporized 2,6-TDI is higher than that of 2,4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2,4-TDA which is a metabolite of illvaporized but well skin-absorbed 2,4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.

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Biological Monitoring of Workers Exposed to Diisocyanates using Urinary Diamines
Jong Seong Lee, Boowook Kim, Jungah Shin, JinEe Baek, Jae Hoon Shin, Ji-hye Kim
Journal of Korean Society of Occupational and Environmental Hygiene.2016; 26(2): 178. CrossRef

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