Occupational Asthma Reference

Suojalehto H, Sastre J, Merimaa E, Lindström I, Suuronen K., Occupational asthma from epoxy compounds., J Allergy Clin Immunol Pract, 2019;7:191-198,10.1016/j.jaip.2018.07.023
(Plain text: Suojalehto H, Sastre J, Merimaa E, Lindstrom I, Suuronen K., Occupational asthma from epoxy compounds., J Allergy Clin Immunol Pract)

Keywords: TGIC, epoxy, os, SIC, ch, Finland, Spain, FeNO, NSBR, or, contact dermatitis, polyamine, am

Known Authors

Joaquin Sastre, Fundacion Jimenez Diaz, Madrid Joaquin Sastre

Hille Suojalehto, Finnish Institute of Occupational Health Hille Suojalehto

Irmeli Lindstrom, Finnish Institute of Occupational Health Irmeli Lindstrom

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Abstract

BACKGROUND:
Two-component epoxy resin systems (ERS) composed of epoxy resin and polyamine hardeners are extensively used in industrial and construction coating. Triglycidyl isocyanurate (TGIC) is another type of epoxy derivative, mostly encountered in polyester powder paints. Epoxy compounds are well known skin sensitizers, but their respiratory sensitizing potential is largely unknown.

OBJECTIVES:
We report patients examined for occupational asthma from epoxy compounds.

METHODS:
We retrospectively reviewed patient files of cases tested with a placebo-controlled specific inhalation challenge (SIC) according to their workplace exposure: either by mixing epoxy resin and the polyamine hardener of a two-component paint or by dusting or heating TGIC-containing powder paint. The data were collected from the Finnish Institute of Occupational Health and at the Fundación Jiménez Díaz Hospital, Spain, in 1997-2018. We also measured airborne polyamine and solvent vapours at the workplace and during SIC with ERS.

RESULTS:
Altogether 113 patients with work-related asthma symptoms underwent SIC with ERS. Fifteen cases (13%) had positive SIC reactions confirming occupational asthma; in 12 cases reactions were late type, in one case early and in two cases combined. The median duration of exposure of occupational asthma patients was ten years, two of them (13%) had a diagnosis of allergic contact dermatitis from ERS compounds. In addition, three cases had a positive SIC reaction to TGIC. The airborne polyamine levels measured were low.

CONCLUSIONS:
ERS and TGIC can cause sensitizer-induced occupational asthma in some exposed workers. Respiratory exposure to ERS is difficult to demonstrate using air measuremen

Plain text: BACKGROUND: Two-component epoxy resin systems (ERS) composed of epoxy resin and polyamine hardeners are extensively used in industrial and construction coating. Triglycidyl isocyanurate (TGIC) is another type of epoxy derivative, mostly encountered in polyester powder paints. Epoxy compounds are well known skin sensitizers, but their respiratory sensitizing potential is largely unknown. OBJECTIVES: We report patients examined for occupational asthma from epoxy compounds. METHODS: We retrospectively reviewed patient files of cases tested with a placebo-controlled specific inhalation challenge (SIC) according to their workplace exposure: either by mixing epoxy resin and the polyamine hardener of a two-component paint or by dusting or heating TGIC-containing powder paint. The data were collected from the Finnish Institute of Occupational Health and at the Fundacion Jimenez Diaz Hospital, Spain, in 1997-2018. We also measured airborne polyamine and solvent vapours at the workplace and during SIC with ERS. RESULTS: Altogether 113 patients with work-related asthma symptoms underwent SIC with ERS. Fifteen cases (13%) had positive SIC reactions confirming occupational asthma; in 12 cases reactions were late type, in one case early and in two cases combined. The median duration of exposure of occupational asthma patients was ten years, two of them (13%) had a diagnosis of allergic contact dermatitis from ERS compounds. In addition, three cases had a positive SIC reaction to TGIC. The airborne polyamine levels measured were low. CONCLUSIONS: ERS and TGIC can cause sensitizer-induced occupational asthma in some exposed workers. Respiratory exposure to ERS is difficult to demonstrate using air measuremen

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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What is the feasibility of obtaining paired measurements of non-specific reactivity at and away from work?
burgeps changes in NSBR in 2/7 mostly with late SIC reactions to epoxy resin systems
What is the role of exhaled breath Nitric Oxide in the diagnosis and management of occupational asthma.
burgeps changes in FeNO in 2/7 mostly with late SIC reactions to epoxy resin systems

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Comments

A case series from Helsinki and Madrid of 15 workers with a positive SIC to polyamines (unspecified) used in epoxy resin systems, and 3 powdercoaters with TGIC reactions. Of the polyamines 12/15 had late reactions and 2/15 dual reactions. Changes in NSBR were seen in 2/7 (29%) and FeNO in 2/7 (29%). Mrean time from first exposure 10 years and time with symptoms 1.9 years. Many were making windmills. Work related rhinitis in about half, 2/3 TGIC positive in 2/3 TGIC reactors (No comment on whether the third kept PEF records). 13% had contact dermatitis. Air measurements of polyamines very low.
1/27/2021

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