isocyanates allergic asthma

Isocyanate-Induced Allergic Asthma: A Serious Occupational Hazard

Isocyanates are a group of chemicals commonly used in the production of polyurethane foams, coatings, and adhesives. However, exposure to these substances can have severe consequences on human health, particularly the respiratory system.

Symptoms and Effects

Allergic asthma caused by isocyanate exposure can manifest in various ways, including:

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Symptoms of Isocyanate-Induced Allergic Asthma

Isocyanate-induced allergic asthma can manifest in various ways, making it essential to recognize the signs and symptoms early on. Here are some common indicators:

• Respiratory issues: Wheezing, coughing, chest tightness, and shortness of breath are all possible symptoms of isocyanate-induced allergic asthma [12][13].
• Skin and mucous membrane irritation: Exposure to isocyanates can cause skin and mucous membrane irritation, which may lead to redness, itching, and burning sensations [5][10].
• Asthma exacerbations: Once sensitized to isocyanates, individuals may experience asthma exacerbations when exposed to these chemicals again [3][9].

Other Possible Symptoms

In addition to the above symptoms, some people may also experience:

• Runny nose
• Nasal congestion
• Eye irritation
• Headaches

It's essential to note that these symptoms can be similar to those experienced in other types of asthma or respiratory conditions. If you suspect isocyanate-induced allergic asthma, consult a healthcare professional for proper diagnosis and treatment.

References

[3] - Breathing in isocyanates can cause you to develop an allergic reaction (respiratory sensitisation). Sensitisation may develop as a result of a large single exposure, or from repeated exposure at lower levels. Once you’ve become sensitised, it can trigger asthma symptoms when you breathe it in [3].

[5] - Isocyanates are skin, eye, respiratory, and gastrointestinal irritants. They are also powerful sensitizers that have caused severe asthma, which has been fatal in some instances. Isocyanates can also cause contact dermatitis (both irritant and allergic forms) and hypersensitivity pneumonitis [5].

[9] - Occupational asthma symptoms are the same as any asthma exacerbation, such as wheezing, shortness of breath, runny nose, nasal congestion, eye irritation, and ... [9]

[10] - Exposure to isocyanates can cause contact dermatitis, skin and respiratory tract irritation, sensitization, and asthma. Both skin and inhalation exposure can lead to these symptoms [10].

[12] - Symptoms may include coughing, wheezing and chest tightness. Once a person has become sensitised to isocyanates, it can trigger asthma symptoms when breathed in [12].

Diagnostic Tests for Isocyanate Allergic Asthma

Isocyanate-induced asthma can be challenging to diagnose, but various tests are available to help confirm the condition. Here are some diagnostic tests used to detect isocyanate allergic asthma:

• Specific Inhalation Challenge (SIC): This is considered the gold-standard test for diagnosing isocyanate-induced asthma. However, it's technically and economically demanding, and only available in a few specialized centers [1].
• Quantitative Allergen-Specific IgE Testing: This test measures the level of specific IgE antibodies against isocyanates in the blood. It can be useful in diagnosing a subset of workers with isocyanate asthma [2].
• RAST (RadioAllergoSorbent Test) Score: A RAST score of 3 or greater is considered diagnostic for isocyanate-induced asthma, and the sensitivity of specific IgE measurement is high in this context [5][8].
• Skin Patch Test: A skin specialist can perform a patch test to determine if a worker's

Treatment Options for Isocyanate-Induced Allergic Asthma

Isocyanate-induced allergic asthma can be effectively managed with a combination of medications and avoidance of exposure to the allergen. Here are some treatment options:

• High-dose inhaled corticosteroids: These are considered the first-line treatment for isocyanate-induced asthma, as they have been shown to reduce inflammation and improve lung function (5).
• Long-acting beta2 agonists: These medications can be added to high-dose inhaled corticosteroids to further improve lung function and control symptoms (5).
• Oral corticosteroids: High-dose oral corticosteroids may be prescribed for short periods to manage severe asthma exacerbations (5).
• Omalizumab: This medication has been shown to be effective in reducing symptoms and improving quality of life in patients with isocyanate-induced asthma (4).

Other Treatment Considerations

• Avoidance of exposure: The most effective treatment for isocyanate-induced allergic asthma is avoidance of exposure to the allergen. This can involve changing work environments or taking precautions when working with isocyanates.
• Monitoring and follow-up: Regular monitoring and follow-up appointments with a healthcare provider are essential to ensure that symptoms are being effectively managed and to make any necessary adjustments to treatment plans.

References

[4] Prednisolone treatment in bronchial asthma: clinical improvement is accompanied by reduction in bronchoalveolar lavage eosinophilia and modulation of IL-4 ... (Context #4) [5] Step 6: The preferred treatment is high-dose inhaled corticosteroid plus a long-acting beta2 agonist plus an oral corticosteroid; consider omalizumab with ... (Context #5)

Differential Diagnosis of Isocyanate Allergic Asthma

Isocyanate allergic asthma is a type of occupational asthma caused by exposure to diisocyanates, which are highly reactive chemicals widely used in various industries. The differential diagnosis of this condition involves identifying other possible causes of asthma that may mimic the symptoms and presentation of isocyanate-induced asthma.

Other Possible Causes of Asthma

• High-molecular-weight agents: These include proteins such as latex or animal dander, which can cause allergic reactions and asthma.
• Low-molecular-weight agents: These include chemicals like diisocyanates, which are known to cause occupational asthma.
• Irritant contact dermatitis: This is a skin reaction caused by exposure to irritants, which can also affect the respiratory system.
• Hypersensitivity pneumonitis: A lung reaction that occurs in response to inhalation of certain substances.

Key Considerations for Differential Diagnosis

• Occupational history: A thorough occupational history is essential to identify potential exposures to diisocyanates or other chemicals.
• Immunologic tests: These can help determine the presence of specific antibodies or sensitization to certain agents.
• Clinical presentation: The symptoms and presentation of asthma, such as wheezing, coughing, and shortness of breath, should be carefully evaluated.

References

1. by K Nakashima · 2002 · Cited by 10 — The accurate diagnosis of diisocynate asthma requires a systematic approach that combines information obtained from the occupational history, immunologic tests ...
2. by A Fisseler-Eckhoff · 2011 · Cited by 66 — In addition, allergy-induced asthma can be caused by two different groups of agents: high molecular weight proteins (>5,000 Da) or low molecular weight agents ...
3. Exposure to isocyanate can result in allergic contact dermatitis, irritant contact dermatitis, contact urticaria, and generalised urticaria.
4. Diisocyanates are among chemicals known to cause asthma in the workplace, however the incidence of diisocyanate-related asthma has been decreasing.

Citations

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• [2]
• [3]
• [4]