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Evaluation of Self-Reported Skin Problems Among Workers Exposed to Toluene Diisocyanate (TDI) at a Foam Manufacturing Facility

Daftarian, Helga S. DO, MPH; Lushniak, Boris D. MD, MPH; Reh, Christopher M. PhD, CIH; Lewis, Daniel M. PhD

Journal of Occupational and Environmental Medicine: December 2002 - Volume 44 - Issue 12 - p 1197-1202
Original Articles

Toluene diisocyanate, or TDI (CAS 584-84-9) is a well-known asthmagen and respiratory irritant. TDI is also known for its ability to irritate the skin and mucous membranes. To further investigate the dermal effects of TDI, NIOSH investigators conducted a cross-sectional study at a flexible foam manufacturing plant. A total of 114 workers participated in the study. Participants completed a medical questionnaire, provided blood for antibody testing to TDI and other allergens, and a subset of participants reporting skin symptoms underwent skin patch testing to a standard diisocyanate panel. Production line workers were more than twice as likely to report skin problems as those working in nonproduction areas (PRR = 2.66; 95% CI = 1.14–16.32; P = 0.02). Age, gender and duration of employment at the plant were comparable among participants working in production and nonproduction areas. Of the 100 participants who provided blood samples for antibody testing, specific IgG antibody to TDI was detected in two individuals, and none of the samples demonstrated specific IgE antibody to TDI. Of the 26 workers who underwent skin patch testing, none developed reactions to the diisocyanate allergens. These results suggest that the skin symptoms among study participants represent an irritant rather than an immunologic reaction to TDI, or to an unidentified allergen present in the foam.

From the Health Services Department, General Motors North America Moraine Assembly Plant, Dayton, OH (Dr Daftarian); Centers for Disease Control and Prevention, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH (Dr Lushniak); Occupational Hygiene and Safety, The Gillette Company, Needham, Massachusetts (Dr Reh); Analytical Services Branch, Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV (Dr Lewis).

Address correspondence to: Helga S. Daftarian, DO, MPH, Medical Director, Health Services Department, General Motors North America Moraine Assembly Plant, 2601 W. Stroop Road, Dayton Ohio 45439-1929; e-mail:

This article was written by an officer or employee of the US Government as part of his/her official duties and is therefore not subject to US copyright.

Copyright © 2002 by the American College of Occupational and Environmental Medicine