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Challenge Exposure to Isocyanates Induces Changes in Nasal Patency in Patients Reporting Work-Related Respiratory Symptoms

Castano, Roberto MD, PhD; Johnson, Victor J. PhD; Cartier, Andre MD

Journal of Occupational and Environmental Medicine: August 2013 - Volume 55 - Issue 8 - p 954–959
doi: 10.1097/JOM.0b013e318293aef9
Original Articles

Objective: To examine the utility of specific inhalation challenge (SIC) in assessing the nasal congestive response to isocyanate exposure.

Methods: Nine patients complaining of work-related respiratory symptoms underwent SIC with exposure to isocyanate for 4 and 120 minutes on different days. Nasal volume was monitored by acoustic rhinometry and nasal congestion by the visual analogue scale (VAS) for up to 6 hours.

Results: The 4-minute isocyanate SIC induced a nonsignificant fall in nasal volume and no increase in the VAS score. The 120-minute isocyanate SIC induced a significant fall in nasal volume at 15, 30, and 60 minutes postchallenge that was associated with a significant increase in the VAS score at 15 and 30 minutes postchallenge.

Conclusions: SIC appears useful to assess changes in nasal patency after exposure to isocyanate. Exposure to isocyanates can induce nasal congestion that can be objectively monitored during SIC.

Supplemental Digital Content is Available in the Text.

From the Division of Otolaryngology–Head and Neck Surgery (Dr Castano), University of Montreal; Chronic Disease Research Division (Drs Castano and Cartier), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; BRT-Burleson Research Technologies (Dr Johnson), Morrisville, NC; and Department of Chest Medicine (Dr Cartier), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada.

Address correspondence to: Roberto Castano, MD, PhD, Department of Surgery/Division of Otolaryngology, Hôpital du Sacré-Coeur de Montréal, 5400 boulevard Gouin West, Montréal, QC H4J 1C5, Canada (

This study was supported by the Center for Asthma in the Workplace, a Canadian Institute of Health Research.

The authors declare no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2013 by the American College of Occupational and Environmental Medicine