Respiratory health surveillance in a toluene di-isocyanate production unit, 1967-97: clinical observations and lung function analyses
M Gerald Otta, Julia E Kleesa, Sandy L Pocheb
a Corporate Medical
Department, BASF Corporation, Mount Olive, NJ, USA, b Geismar Medical Department,
BASF Corporation, Geismar, LA, USA
Correspondence to: Dr M G Ott, Corporate Medical Department, BASF Corporation, Mount Olive, NJ 07828-1234, USA
Accepted 13 August
1999
OBJECTIVES
To
characterise irritant and allergic airway responses and assess changes
in forced vital capacity (FVC) and forced expiratory volume in 1 second
(FEV1) relative to exposure to toluene di-isocyanate (TDI).
METHODSEmployees
(n=313) ever assigned to a TDI production unit for 
3 months
(1967-92) were identified from personnel records along with 158 frequency matched referents without known exposure to TDI. Reports made
during visits to the occupational clinic of incidents related to
exposure to TDI and annual periodic examination results (questionnaire,
physical findings, and spirometry) were abstracted and assessed
relative to industrial hygiene estimates of exposure to TDI.
RESULTSMean 8 hour time weighted average estimates of TDI concentrations ranged from
9.9 ppb in jobs with potentially high exposure during the early years
of plant operations to 0.5 ppb in jobs with potentially low exposure in
more recent years. The corresponding rates of visits to the clinic due
to incidents of exposure to TDI (including both irritant and allergic
airway responses) declined from 20.5 to 1.0 visits per 100 years of
employment at the unit. The annual incidence of asthma induced by
TDI declined from 1.8% before 1980 to 0.7% afterwards. Neither cross
sectional nor longitudinal analyses of FVC and FEV1 showed
significant dose-response findings relative to exposure to TDI across
the total exposed population. Among cases of occupational asthma there
was an apparent initial decline in FEV1 within 2 years of
first reporting symptoms, but not an accelerated rate of decline in
follow up tests from 4-30 years after induction of asthma.
CONCLUSIONSOccurrences
of both asthma induced by TDI and irritant airway responses due to
exposure to TDI were found in this cohort, but there was no relation
between cumulative exposure to TDI and irreversible airflow obstruction
as assessed by spirometry.
Keywords: toluene di-isocyanate; lung function decrement; occupational asthma
© 2000 by Occupational and Environmental Medicine
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