Occupational Asthma Reference

Donnelly R, Buick JB, Macmahon J, Occupational asthma after exposure to plaster casts containing methylene diphenyl diisocyanate., Occup Med (Oxford), 2004;54:432-434,

Keywords: Ireland, healthcare, isocyanate, MDI, case report, nurse, challenge

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BACKGROUND: The case of a 34-year-old female nurse is presented. She worked in an accident and emergency department in a district general hospital, with methylene diphenyl diisocyanate (MDI)-containing synthetic plaster casts. She worked with MDI on a daily basis for 4 years. She was out of the department for 1 year and on her return developed cough, wheeze and dyspnoea within 5 min of exposure to MDI- containing synthetic casts.

METHOD: A bronchial provocation test was performed and confirmed an early asthmatic response.

RESULTS: There was a 39% decrease in the forced expiratory volume in 1 s 15 min after exposure, which required the administration of a bronchodilator on two occasions. The patient has subsequently avoided MDI-containing synthetic plaster casts and has experienced no further respiratory symptoms.

CONCLUSION: This case illustrates that respiratory sensitization can occur as a result of exposure to MDI-containing synthetic casts and highlights the need for vigilance when health care workers are using isocyanate-containing synthetic casts.

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