Bernstein DI, Korbee L, Stauder T, Bernstein JA, Scinto J, Herd ZL, Bernstein IL, The low prevalence of occupational asthma and antibody-dependent sensitisation to diphenylmethane di-isocyanate in a plant engineered for minimal exposure to di-isocyanates, J Allergy Clin Immunol, 1993;92:387-396,

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.

A study of 243 workers exposed to diphenylmethane di-isocyanate (MDI) was conducted in a plant that had been designed to minimize MDI. On the basis of questionnaire responses, diagnoses were derived that included occupational asthma; non-OA; work-related and non-work-related rhinitis; and lower respiratory irritant responses. PEFR values were abnormal in 3/9 workers with occupational asthma, in 2/4 with non-OA, and in 2/23 case control subjects. A significant association was found between peak flow rate variability and a questionnaire asthma diagnosis. Physicians confirmed 3 cases of occupational asthma, one of which in symptom-free control worker). In all 3 cases asthma symptoms remitted after the worker left the workplace. On the basis of these cases, specific work activities associated with exposure to MDI were identified and corrective measures were instituted. Strict control and monitoring of ambient MDI exposure was associated with a low prevalence of specific sensitisation to MDI and a lower than expected prevalence of occupational asthma.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 3 Spirometry detects few cases of occupational asthma that would not otherwise be detected by respiratory questionnaire.

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