Korean J Asthma Allergy Clin Immunol.  2005 Sep;25(3):223-227.

A Case of Chromium- and Toluene Diisocyanate-Induced Asthma

Abstract

There have been case reports of occupational asthma (OA) due to chromium in cement workers. Isocyanates are used in the manufacture of numerous products, such as polyurethane paints, and are known to be the most common cause of OA. We report herein a case of OA due to both chromium and toluene diisocyanate (TDI) in a construction worker. A 60-year-old man had been employed as a cement worker and painter in a construction company. He had suffered from dyspnea, rhinorrhea, and headache during working with cement powder or painting. He was diagnosed as having asthma, based on significant reversibility of airway obstruction. A bronchial provocation test (BPT) with chromium showed no asthmatic response. However, airway hyperresposiveness to methacholine and sputum eosinophils were significantly increased 24 hours after BPT. BPT with cement powder revealed a dual response. BPT with TDI showed a progressive asthmatic response associated with increased airway hyperresponsiveness and sputum eosinophils. A patch test to chromium was positive. This case proves that both chromium and TDI can induce OA simultaneously in the construction worker.

MeSH Terms

Airway Obstruction
Asthma*
Asthma, Occupational
Bronchial Provocation Tests
Chromium
Dyspnea
Eosinophils
Headache
Humans
Isocyanates
Methacholine Chloride
Middle Aged
Paint
Paintings
Patch Tests
Polyurethanes
Sputum
Toluene 2,4-Diisocyanate
Toluene*
Chromium
Isocyanates
Methacholine Chloride
Polyurethanes
Toluene
Toluene 2,4-Diisocyanate