Isocyanate Skin and Air Exposure: Assessment and Control

描述（由申请人提供）： 这是第二次修订的一项RO1提案，旨在调查MDI织物涂层工厂中的异氰酸酯皮肤和空气暴露，并实施一项现场干预计划，以减少异氰酸酯皮肤暴露。反应性异氰酸酯广泛用作生产聚氨酯的基本交联剂，50多年来一直是职业性哮喘的主要原因。直到最近，人们一直认为呼吸道是异氰酸酯接触的主要途径，迄今为止，临床实践、研究和预防几乎完全集中在空气传播的接触上。越来越多的证据表明，异氰酸酯皮肤暴露可导致异氰酸酯哮喘的发展。尽管减少了呼吸道异氰酸酯暴露，但异氰酸酯哮喘仍在继续发生，通常发生在测量的空气传播水平低于监管标准的工作环境中，以及有机会皮肤暴露的地方。 本拟议项目是一项实地干预研究，旨在评估和减少一家雇用约100名工人的计量吸入器聚氨酯织物涂层厂的异氰酸酯接触情况。该工厂最近的一项健康调查显示，对MDI的敏感性普遍存在，尽管MDI空气中的浓度基本上无法检测到，但在所有工人中有三分之一以上的人检测到MDI IgG。具体目标是：目标1）使用基于定量空气和皮肤采样数据以及接触生物标志物的接触算法，确定基线个体工人MDI呼吸和皮肤接触的特征目标2）确定工人的健康状况和早期疾病标志物目标3）设计和实施综合干预方案，以减少异氰酸酯皮肤接触评估干预计划的有效性该研究将涉及对工人的呼吸和皮肤暴露、健康状况和选定的生物标志物的初步定量评估。随后将制定和实施一项综合干预计划，以减少MDI皮肤接触。将通过比较干预前后的工作实践、MDI暴露和相关生物标志物来评估干预计划的有效性。这些发现应该大大扩展我们对异氰酸酯皮肤暴露的了解，并确定减少此类暴露的有效策略。调查结果应与越来越多的最终用途MDI聚氨酯工作环境有关。 公共卫生相关性：异氰酸酯是广泛使用的化学品，对生产许多聚氨酯泡沫和其他产品至关重要，仍然是职业性哮喘的主要原因。迄今为止的研究和控制主要集中在空气中的照射。尽管接触的空气水平降低，但工人继续患上异氰酸酯哮喘。最近的研究表明，异氰酸酯皮肤暴露，这是很难监测和控制，可能在异氰酸酯哮喘的发展中发挥重要作用。该项目将是一项实地干预研究，旨在评估聚氨酯涂料厂中皮肤接触异氰酸酯的程度和健康影响，并确定减少此类接触的有效战略。这些发现应该与生产和使用聚氨酯产品的数百万工人有关。

DESCRIPTION (provided by applicant): This is the second revision of a RO1 proposal to investigate isocyanate skin and air exposures in an MDI fabric coating factory and implement a field intervention program to reduce isocyanate skin exposures. Reactive isocyanates, widely used as the essential cross-linker for producing polyurethane, have been a leading cause of occupational asthma for over 50 years. Until recently it has been presumed that the respiratory tract is the key route of isocyanate exposure, with clinical practice, research and prevention to-date focused almost exclusively on airborne exposures. There is growing evidence that isocyanate skin exposure can contribute to the development of isocyanate asthma. Despite reduced respiratory isocyanate exposures, isocyanate asthma continues to occur, commonly in work environments where measured airborne levels are below regulatory standards, and also where there is opportunity for skin exposure. This proposed project is a field intervention study aimed at assessing and reducing isocyanate exposures in an MDI polyurethane fabric coating plant employing approximately 100 workers. A recent health survey at this plant showed a high prevalence of sensitization to MDI, with MDI IgG detected in over 1/3 of all workers, despite largely non-detectable MDI air levels. The Specific Aims will be to: Aim 1) Characterize baseline individual worker MDI respiratory and skin exposures using an exposure algorithm based on quantitative air and skin sampling data and biomarkers of exposure Aim 2) Characterize the health status of workers and markers of early disease Aim 3) Design and implement an integrated intervention program to reduce isocyanate skin exposures Aim 4) Evaluate the effectiveness of the intervention program The study will involve an initial quantitative assessment of the worker's respiratory and skin exposures, health status, and selected biomarkers. This will be followed by development and implementation of an integrated intervention program to reduce MDI skin exposures. The effectiveness of the intervention program will be evaluated by comparing work practices, MDI exposures, and relevant biomarkers before and after the intervention. The findings should substantially extend our knowledge concerning isocyanate skin exposure and identify effective strategies to reduce such exposures. The findings should be relevant to the growing number of end-use MDI polyurethane work settings. Public Health Relevance: Isocyanates, widely used chemicals essential to the production of numerous polyurethane foams and other products, remain a leading cause of occupational asthma. Research and controls to-date have focused largely on airborne exposures. Despite reduced air levels exposed workers continue to develop isocyanate asthma. Recent studies suggest that isocyanate skin exposures, which are difficult to monitor and control, may play an important role in the development of isocyanate asthma. This project will be a field intervention study aimed at assessing the extent and health impact of skin exposures to isocyanates in a polyurethane coating factory and also identifying effective strategies to reduce such exposures. The findings should be relevant to the millions of workers who produce and use polyurethane products.