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. 2012 Jun;21(124):112–124. doi: 10.1183/09059180.00005111

Table 4. Selected literature on occupational skin exposure to isocyanates.

First author [ref.] Main conclusion Origin Study type Exposure/occupation Subjects
Pronk [19] Inhalation HDI exposure associated with tasks involving aerosolisation
Skin exposure assessed by extraction of HDI from nitrile gloves; associated with paint-handling tasks and glove use
HDA detected in 36% of repair shop workers, 10% of industrial workers
HDI oligomers main exposure
Literature search Cross-sectional study
Before and after shift sampling
HDI oligomers, auto-body repair workers 68 paired inhalation and skin samples from auto repair shops; 239 urine samples from 45 workers
27 paired inhalation and skin samples from five industrial companies; 52 urine samples from 10 painters
Robert [55] MDA detectable in 73% of post-shift urine samples; significantly higher than pre-shift levels
Highest MDA levels associated with spraying or hot processes
Skin exposure associated with significant MDA levels in urine
Literature search Cross-sectional study MDI polyurethane workers 169 workers from 19 French factories and 120 controls
Bello [56] Quantitative skin wipe sampling method developed
92% of samples under PPE had detectable isocyanate levels, mostly pHDI
Highest total isocyanate concentrations associated with spraying and mixing
Literature search Cross-sectional study HDI auto-body repair workers 185 samples from 81 auto-body shop painters and technicians during different tasks
43 samples under PPE
Todd [57] 8–21% of workers exposed to mixtures of chemicals more than OELs; 39–69% of surface samples positive for isocyanates using qualitative CLI Swypes™#
PPE and IH controls not adequate
Literature search Cross-sectional study Workers at footwear and equipment factories 286 personal air samples, 64 surface, tool or hand samples from four factories in Thailand
Fent [58] Log-transformed concentrations of HDI in skin of workers correlated with log-transformed product of air concentration and painting time (r=0.79, p<0.001) Literature search Cross-sectional study HDI auto-body spray painters 13 auto-body spray painters: air and skin samples
Liu [59] Skin exposure algorithm using diaries, task-based skin sampling and PPE
Median daily skin exposure index estimated for each worker
Associated with job category
Weakly correlated with daily airborne exposure
Literature search Cross-sectional study Workers in auto-body shops 232 workers in 33 shops:
893 exposure person-days skin exposure, work diary
Fent [60] Isocyanurate predominant isocyanate
Dermal HDI concentrations higher in those not wearing gloves/overalls
Isocyante detected on skin during 23% of paint tasks
Linear mixed modelling identified breathing-zone concentration and paint time significant predictors skin concentration
Literature search Cross-sectional study HDI auto-body spray painters 47 spray painters dermal and inhalational exposure assessment
15 painters no gloves
Flack [61] HDA detected in 76% plasma samples
Correlation between plasma HDA and same day dermal exposures, low but significant, correlation between HDA and 20–60 day dermal exposure higher (r=0.36)
Literature search Cohort study HDI auto-body shop painters 46 spray painters: blood, inhalation and dermal exposures measured
288 tasks
Liljelind [62] Average personal air concentrations below Swedish exposure limit
Tape stripping used to measure MDI skin exposure
Decreasing levels of MDI in consecutive tape strips per site indicate dermal penetration
Literature search Cross-sectional study MDI iron-foundry workers 19 workers in different areas of foundry; tape strip dermal sampling repeated on five exposed skin areas and air sampling

HDI: hexamethylene diisocyanate; HDA: hexamethylene diamine; MDA: methylenedianiline diisocyanate; MDI: methylene diphenyl diisocyante; PPE: personal protective equipment; pHDI: polymeric HDI isocyanate; OEL: occupational exposure limit; IH: industrial hygiene. #: skin wipes that provide a visible indication of skin exposure (Colorimetric Laboratories, Inc., Plaines, IL, USA).