Wednesday, January 15, 2014

Prevent adult-onset occupational asthma

Isocyanates (eye-so-sigh-a-nates) are chemicals that can cause asthma and cancer, irritate the skin, eyes, nose and throat, and even cause death.  It is important for medical providers to know the health risks associated with isocyanates and be aware that patients who work in certain industries are in danger of being exposed.  The risks are so well documented that the Occupational Safety and Health Administration (OSHA) has announced an emphasis program to protect workers from exposure to isocyanates.
Patients potentially exposed to isocyanates may have:
  • Persistent or recurring eye irritation
  • Nasal congestion
  • Dry or sore throat
  • Cold-like symptoms
  • Cough
  • Shortness of breath
  • Wheezing
  • Chest-tightness
Direct skin contact can cause:
  • Sensitization
  • Inflammation
  • Rash
  • Itching
  • Hives
  • Swelling
Isocyanates are found in the following compounds:
  • Paints
  • Varnishes
  • Foams
  • Sealants
They are used in the following industries:
  • Residential/commercial construction to coat cement, wood, fiberglass, steel and aluminum
  • Automotive painting and spray on bed-liners
  • Commercial manufacturing of ridged and flexible foams
  • Boatbuilding coatings to protect boats
When dealing with a patient, medical providers should consider that patient's occupation and work environment. Isocyanates are powerful irritants to the eyes, gastrointestinal, and respiratory tracts. Isocyanates can sensitize a patient through skin contact which means a patient could be subject to a severe asthma attack if they come into contact again (death from severe asthma in some sensitized subjects has been reported).  Isocyanates cannot easily be washed off skin or clothing because they are not water soluble.  OSHA is hoping that by focusing on this problem it will raise physician awareness of the risk, reduce employee exposure, and lessen the overall negative health effects associated with isocyanates. 
For more on the National Emphasis Program, visit: (See appendix C for a patient questionnaire.)

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