Nielsen J, Welinder H, Jonsson B et al, Exposure to hexahydrophthalic and methylhexahydrophthalic anhydrides--dose-response for sensitisation and airway effects, Scand J Work Environ Health, 2001;27:327-334,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Study aimed to clarify the exposure-response relationships for the organic acid anhydrides (OAA) hexahydrophthalic and methylhexahydrophthalic anhydrides and the development of specific IgE, IgG antibodies and work-related symptoms in 154 exposed workers and 57 referents. Air levels of the OAA were low and associated with the concentrations of the OAA metabolites in urine. Furthermore, for the exposed workers, there were high prevalences of sensitisation (IgE 22%, IgG 21%), which correlated with the exposure. Neither atopy nor smoking increased this risk significantly. Work-related symptoms were more prevalent among the exposed workers than among the referents. Authors conclude that in spite of the very low OAA levels in the air and metabolites in the urine, there were high and exposure-related risks of specific IgE and IgG sensitisation and of work-related symptoms for the eyes, nose (especially bleeding), and lower airways.

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