Abstract
Two police officers developed asthma like illness after a single but prolonged exposure to toluene diisocyanate (TDI) by being in the immediate vicinity of a tank car that had overturned on a highway. One officer experienced upper and lower respiratory tract symptoms with chest tightness about 4.5 hours after initial exposure. Shortness of breath, cough, and wheezing were noted the following day. The other experienced symptoms immediately on exposure, developed shortness of breath 20 minutes later, and presented with wheezing four hours after that. Follow up examinations over seven years showed persistence of respiratory symptoms and continuation of airway hyperreactivity requiring treatment.
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Selected References
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- Axford A. T., McKerrow C. B., Jones A. P., Le Quesne P. M. Accidental exposure to isocyanate fumes in a group of firemen. Br J Ind Med. 1976 May;33(2):65–71. doi: 10.1136/oem.33.2.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bernstein I. L. Isocyanate-induced pulmonary diseases: a current perspective. J Allergy Clin Immunol. 1982 Jul;70(1):24–31. doi: 10.1016/0091-6749(82)90197-x. [DOI] [PubMed] [Google Scholar]
- Boushey H. A., Holtzman M. J., Sheller J. R., Nadel J. A. Bronchial hyperreactivity. Am Rev Respir Dis. 1980 Feb;121(2):389–413. doi: 10.1164/arrd.1980.121.2.389. [DOI] [PubMed] [Google Scholar]
- Brooks S. M., Weiss M. A., Bernstein I. L. Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest. 1985 Sep;88(3):376–384. doi: 10.1378/chest.88.3.376. [DOI] [PubMed] [Google Scholar]
- Durlacher S. H., Bunting H. Pulmonary Changes Following Exposure to Phosgene. Am J Pathol. 1947 Sep;23(5):679–693. [PMC free article] [PubMed] [Google Scholar]
- Karol M. H. Respiratory effects of inhaled isocyanates. Crit Rev Toxicol. 1986;16(4):349–379. doi: 10.3109/10408448609037467. [DOI] [PubMed] [Google Scholar]
- Mapp C. E., Corona P. C., De Marzo N., Fabbri L. Persistent asthma due to isocyanates. A follow-up study of subjects with occupational asthma due to toluene diisocyanate (TDI). Am Rev Respir Dis. 1988 Jun;137(6):1326–1329. doi: 10.1164/ajrccm/137.6.1326. [DOI] [PubMed] [Google Scholar]
- Mastromatteo E. Recent occupational health experiences in Ontario. J Occup Med. 1965 Oct;7(10):502–511. [PubMed] [Google Scholar]
- O'Brien I. M., Harries M. G., Burge P. S., Pepys J. Toluene di-isocyanate-induced asthma. I. Reactions to TDI, MDI, HDI and histamine. Clin Allergy. 1979 Jan;9(1):1–6. doi: 10.1111/j.1365-2222.1979.tb01516.x. [DOI] [PubMed] [Google Scholar]
- Peters J. M., Murphy R. L. Pulmonary toxicity of isocyanates. Ann Intern Med. 1970 Oct;73(4):654–655. doi: 10.7326/0003-4819-73-4-654. [DOI] [PubMed] [Google Scholar]
- Peters J. M., Wegman D. H. Epidemiology of toluene diisocyanate (TDI)-induced respiratory disease. Environ Health Perspect. 1975 Jun;11:97–100. doi: 10.1289/ehp.751197. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson J. E., Scypinski L. A., Gordon T., Sheppard D. Tachykinins mediate the acute increase in airway responsiveness caused by toluene diisocyanate in guinea pigs. Am Rev Respir Dis. 1987 Jul;136(1):43–49. doi: 10.1164/ajrccm/136.1.43. [DOI] [PubMed] [Google Scholar]
- Walters E. H., Parrish R. W., Bevan C., Smith A. P. Induction of bronchial hypersensitivity: evidence for a role for prostaglandins. Thorax. 1981 Aug;36(8):571–574. doi: 10.1136/thx.36.8.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zaid G., Beall G. N. Bronchial response to beta-adrenergic blockade. N Engl J Med. 1966 Sep 15;275(11):580–584. doi: 10.1056/NEJM196609152751103. [DOI] [PubMed] [Google Scholar]