Isocyanates, polyurethane and childhood asthma

Polyhydroxyurethane and Poly(ethylene oxide) Multiblock Copolymer Networks: Crosslinking with Polysilsesquioxane, Reprocessing and Solid Polyelectrolyte Properties

This contribution reports the synthesis of polyhydroxyurethane (PHU)-poly(ethylene oxide) (PEO) multiblock copolymer networks crosslinked with polysilsesquioxane (PSSQ). First, the linear PHU-PEO multiblock copolymers were synthesized via the step-growth polymerization of bis(6-membered cyclic carbonate) (B6CC) with α,ω-diamino-terminated PEOs with variable molecular weights. Thereafter, the PHU-PEO copolymers were allowed to react with 3-isocyanatopropyltriethoxysilane (IPTS) to afford the derivatives bearing triethoxysilane moieties, the hydrolysis and condensation of which afforded the PHU-PEO networks crosslinked with PSSQ. It was found that the PHU-PEO networks displayed excellent reprocessing properties in the presence of trifluoromethanesulfonate [Zn(OTf)2]. Compared to the PHU networks crosslinked via the reaction of difunctional cyclic carbonate with multifunctional amines, the organic-inorganic PHU networks displayed the decreased reprocessing temperature. The metathesis of silyl ether bonds is responsible for the improved reprocessing behavior. By adding lithium trifluoromethanesulfonate (LiOTf), the PHU-PEO networks were further transformed into the solid polymer electrolytes. It was found that the crystallization of PEO chains in the crosslinked networks was significantly suppressed. The solid polymer electrolytes had the ionic conductivity as high as 7.64 × 10-5 S × cm-1 at 300 K. More importantly, the solid polymer electrolytes were recyclable; the reprocessing did not affect the ionic conductivity.

Toxic inhalation of sodium metabisulphite by-products from a shipping container

Logistics workers who handle cargo containers are at risk of toxic inhalation injuries, although prevalence and severities of these injuries are not well characterized. We report on a previously healthy 37-year-old supervisor who was acutely exposed to sodium metabisulphite and its thermal degradation by-products during a routine inspection of a shipping container. The employee developed chemical pneumonitis with acute non-cardiogenic pulmonary oedema and subsequent severe reactive airway dysfunction syndrome.

Early life exposure to outdoor air pollution and indoor environmental factors on the development of childhood allergy from early symptoms to diseases

BACKGROUND

The prevalence of childhood allergies has increased during past decades leading to serious hospitalization and heavy burden worldwide, yet the key factors responsible for the onset of early symptoms and development of diagnosed diseases are unclear.

OBJECTIVE

To explore the role of early life exposure to ambient air pollution and indoor environmental factors on early allergic symptoms and doctor diagnosed allergic diseases.

METHODS

A retrospective cohort study of 2598 preschool children was conducted at 36 kindergartens in Changsha, China from September of 2011 to February of 2012. A questionnaire was developed to survey each child's early onset of allergic symptoms (wheeze and rhinitis-like symptoms) and doctor diagnosis of allergic diseases (asthma and rhinitis) as well as home environments. Each mother's and child's exposures to ambient air pollutants (PM₁₀, SO₂, and NO₂) and temperature were estimated for in utero and postnatal periods. The associations of early symptoms and diagnosed diseases with outdoor air pollution and indoor environmental variables were examined by logistic regression models.

RESULTS

Childhood early allergic symptoms (33.9%) including wheeze (14.7%) and rhinitis-like symptoms (25.4%) before 2 years old were not associated with outdoor air pollution exposure but was significantly associated with maternal exposure of window condensation at home in pregnancy with ORs (95% CI) of 1.33 (1.11-1.59), 1.30 (1.01-1.67) and 1.27 (1.04-1.55) respectively, and was associated with new furniture during first year after birth with OR (95% CI) of 1.43 (1.02-2.02) for early wheeze. Childhood diagnosed allergic diseases (28.4%) containing asthma (6.7%) and allergic rhinitis (AR) (7.2%) were significantly associated with both outdoor air pollutants (mainly for SO₂ and NO₂) during first 3 years and indoor new furniture, redecoration, and window condensation. We found that sex, age, parental atopy, maternal productive age, environmental tobacco smoke (ETS), antibiotics use, economic stress, early and late introduction of complementary foods, and outdoor air pollution modified the effects of home environmental exposure in early life on early allergic symptoms and diagnosed allergic diseases.

CONCLUSION

Our study indicates that early life exposure to indoor environmental factors plays a key role in early onset of allergic symptoms in children, and further exposure to ambient air pollution and indoor environmental factors contribute to the later development of asthma and allergic rhinitis.

New Method to Biomonitor Workers Exposed to 1,6-Hexamethylene Diisocyanate

Isocyanates such as 1,6-hexamethylene diisocyanate (HDI), 4,4'-methylenediphenyl diisocyanate, and toluene diisocyanate are highly reactive compounds that have a variety of commercial applications, including manufacturing polyurethane foam, elastomers, paints, adhesives, coatings, insecticides, and many other products. Their primary route of occupational exposure is through inhalation. Due to their high chemical reactivity, they are toxic and have adverse effects at the cellular and subcellular levels, leading to irritative and immunological reactions associated with lung disease. High concentrations of isocyanates are strong respiratory irritants. Bronchial sensitization and asthma are among the major adverse clinical reactions associated with low-level chronic exposure to isocyanates. Albumin adducts have been linked to the mechanism of occupational asthma caused by isocyanates. Isocyanates react in vivo with albumin, which is recognized by the immune system. Albumin adducts of isocyanates trigger immune responses and are probably the antigenic basis for isocyanate asthma. Sensitization to isocyanates is the main pathway for adverse health effects. Therefore, markers for the biologically effective dose such as albumin adducts of HDI are needed. A new isocyanate adduct of HDI with lysine─N^ε-[(6-amino-hexyl-amino)carbonyl]-lysine (HDI-Lys)─was synthesized and characterized by ¹H-NMR, ¹³C-NMR, and mass spectrometry (MS). Appropriate internal standards─HDI-Lys-4,4'-5,5'-d₄ (HDI-d₄-Lys) and N^ε-[(7-amino-heptyl-amino)carbonyl]-lysine (Hep-Lys)─were synthesized to establish a LC-MS/MS method for the analysis of HDI adducts in in vitro modified albumin and in workers. The presence of HDI-Lys was found after pronase digestion of albumin and confirmed by two independent chromatographic approaches: with a C8 reversed-phase column and with a hydrophilic interaction liquid chromatography column. Quantification was performed with positive electrospray ionization (ESI)-MS. The adduct peak found in vivo was confirmed with the less sensitive negative ESI-MS. In summary, these are new compounds and methods to determine isocyanate-specific adducts with albumin in workers exposed to HDI.

A Non-Isocyanate Route to Poly(Ether Urethane): Synthesis and Effect of Chemical Structures of Hard Segment

A series of non-isocyanate poly(ether urethane) (PEU) were prepared by an environmentally friendly route based on dimethyl carbonate, diols and a polyether. The effect of the chemical structure of polyurethane hard segments on the properties of this kind of PEU was systematically investigated in this work. Polyurethane hard segments with different structures were first prepared from hexamethylene di-carbamate (BHC) and different diols (butanediol, hexanediol, octanediol and decanediol). Subsequently, a series of non-isocyanate PEU were obtained by polycondensation of the polyurethane hard segments with the polyether soft segments (PTMG2000). The PEU were characterized by GPC, FT-IR, ¹H NMR, DSC, WAXD, SAXS, AFM and tensile testing. The results show that the urea groups generated by the side reaction affect the degree of crystallization of hard segments by influencing the hydrogen bonding of the hard segments molecular chains. The degree of hard segment crystallization, in turn, affects the thermal and mechanical properties of the polymer. The urea group content is related to the carbon chain length of the diol used for the synthesis of hard segments. When butanediol is applied to synthesize hard segment, the hard segment of the resulting PEU is unable to crystallize. Therefore, the tensile strength and modulus of elasticity of butanediol-based PEU is lowest among three, though it possesses the highest urea group content. When longer octanediol or decanediol is applied to synthesize the hard segment, the hard segments in the resulting polyether-based polyurethane are crystallizable and the resulting PEU possesses higher tensile strength.

Cosolvent-Driven Interfacial Polymerization for Superior Separation Performance of Polyurea-Based Pervaporation Membrane

A thin-film composite (TFC) polyurea membrane was fabricated for the dehydration of an aqueous tetrahydrofuran (THF) solution through interfacial polymerization, wherein polyethyleneimine (a water-soluble amine monomer) and m-xylene diisocyanate (an oil-soluble diisocyanate monomer) were reacted on the surface of a modified polyacrylonitrile (mPAN) substrate. Cosolvents were used to tailor the membrane properties and increase the membrane permeation flux. Four types of alcohols that differed in the number of carbon (methanol, ethanol, isopropanol, and tert-butanol) were added as cosolvents, serving as swelling agents, to the aqueous-phase monomer solution, and their effect on the membrane properties and pervaporation separation was discussed. Attenuated total reflection Fourier transform infrared spectroscopy confirmed the formation of a polyurea layer on mPAN. Field emission scanning electron microscopy and surface water contact angle analysis indicated no change in the membrane morphology and hydrophilicity, respectively, despite the addition of cosolvents for interfacial polymerization. The TFC membrane produced when ethanol was the cosolvent exhibited the highest separation performance (permeation flux = 1006 ± 103 g·m⁻²·h⁻¹; water concentration in permeate = 98.8 ± 0.3 wt.%) for an aqueous feed solution containing 90 wt.% THF at 25 °C. During the membrane formation, ethanol caused the polyurea layer to loosen and to acquire a certain degree of cross-linking. The optimal fabrication conditions were as follows: 10 wt.% ethanol as cosolvent; membrane curing temperature = 50 °C; membrane curing time = 30 min.

Developing non-isocyanate urethane-methacrylate photo-monomers for 3D printing application

Urethane-methacrylate photo-monomers were prepared via a non-isocyanate route for the 3D printing application. The monomers were synthesized through reacting aliphatic amines, i.e. 1,6-hexanediamine, 1,4-butanediol bis(3-aminopropyl) ether, or n-butylamine, with cyclic carbonates, i.e. ethylene carbonate or propylene carbonate, followed by the methacrylation of the generated hydroxylurethanes. The effects of the chemical structure of monomers on their photo-reactivity and physicomechanical properties of the cured samples were studied. Propylene carbonate generated side methyl groups within the urethane block, which significantly limited the crystallization of the monomers resulting in high photo-reactivity (R p,max = 6.59 × 10-2 s-1) and conversion (DBCtotal = 85%). The ether bonds of 1,4-butanediol bis(3-aminopropyl) ether decreased the intermolecular hydrogen bonding between urethane blocks, which not only improved the photo-reactivity (R p,max = 8.18 × 10-2 s-1) and conversion (DBCtotal = 86%) of the monomer but led to a high crosslinking density (ν c = 5140 mol m-3) and more flexibility for the cured sample. An ink was developed based on the monomers and successfully 3D printed on a digital light processing machine. In the absence of toxic isocyanates and tin compounds, the non-isocyanate route can be employed to develop urethane-methacrylates with desirable photo-reactivity and physicomechanical properties as good candidates to formulate inks for 3D printing of biomedical materials.

Recent developments in etiology and disease modeling of biliary atresia: a narrative review

Biliary atresia (BA) is a rare but severe fibroinflammatory disease of the extrahepatic and the intrahepatic bile ducts. Without prompt interventions, BA has fatal outcomes and is the most common indicator for pediatric liver transplantation (LTx). While the mainstay of treatment involves surgically correcting the extrahepatic biliary obstruction via Kasai hepato-portoenterostomy (KHPE), activation of a multitude of biological pathways and yet-to-be-determined etiology in BA continue to foster liver inflammation, cirrhosis and need for LTx. However, important caveats still exist in our understandings of the biliary pathophysiology, the rapidity of liver fibrosis and progression to liver failure, largely due to limited knowledge of the triggers of biliary injury and the inability to accurately model human BA. Although inconclusive, a large body of existing literature points to a potential viral infection in the early peri- or postnatal period as triggers of epithelial injury that perpetuates the downstream biliary disease. Further confounding this issue, are the lack of in-vivo and in-vitro models to efficiently recapitulate the cardinal features of BA, primarily liver fibrosis. To overcome these barriers in BA research, new directions in recent years have enabled (I) identification of additional triggers of biliary injury linked mostly to environmental toxins, (II) development of models to investigate liver fibrogenesis, and (III) translational research using patient-derived organoids. Here, we discuss recent advances that undoubtedly will stimulate future efforts investigating these new and exciting avenues towards mechanistic and drug discovery efforts and disease-preventive measures. The implications of these emerging scientific investigations and disease modeling in severe fibrosing cholangiopathies like BA are enormous and contribute substantially in our understandings of this rare but deadly disease. These findings are also expected to facilitate expeditious identification of translationally targetable pathways and bring us one step closer in treating an infant with BA, a population highly vulnerable to life-long liver related complications.

Performance of chemically resistant polyurea reverse osmosis membrane in the treatment of highly alkaline industrial wastewater containing sodium aluminate

The goal of the present study is to treat industrial wastewater containing sodium aluminate using a chemically inert polyurea (PU) based thin film composite (TFC) reverse osmosis (RO) membrane to promote water reclamation and zero liquid discharge (ZLD). Pretreatment was carried out to reduce the pH of the effluent from 12.5 to 7.1. The TFC RO membrane was fabricated by coating PU on Polyethersulfone (PES) substrate by interfacial polymerization (IP). The surface and cross-sectional morphologies of the membrane were characterized using scanning electron microscopy (SEM). The indigenously synthesized membrane was effective in the removal of total dissolved solids (TDS), chemical oxygen demand (COD), colour and electrical conductivity. The experiments were conducted by varying the feed composition of the wastewater. The maximum water recovery and flux were found to be 74% and 73.9 L/m^2·h. RO process using PU membrane exhibited significant potential for cost effective, safe and pollution-free treatment of sodium aluminate industrial effluent.

A systematic review and meta-analysis of risk factors associated with atopic dermatitis in Asia

Background

Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterised by intense itch and eczematous lesions. Rising prevalence of AD has been observed worldwide including in Asia. Understanding the risk factors associated with AD may explain its pathogenicity and identify new preventive strategies and treatments. However, AD-associated risk factors and comorbidities specific to Asia have not been systematically reviewed.

Methods

We performed a systematic review in accordance with the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarised epidemiological studies investigating personal, family, and environmental factors and comorbidities associated with AD in Asia. Significant factors were assessed if they can be altered through lifestyle practices and further classified into non-modifiable and modifiable factors. Meta-analysis using the random-effect model was also conducted to provide an overall estimate for several significant factors.

Results

We identified a total of 162 epidemiological studies conducted in Asia. Among non-modifiable factors, a family history of atopic diseases was the most reported, suggesting the involvement of genetics in AD pathogenesis. Among modifiable factors, the results of meta-analyses revealed maternal smoking as the strongest risk factor with a pooled odds ratio (OR) of 2.95 (95% CI, 2.43-3.60), followed by active smoking (pooled OR, 1.91, 95% CI, 1.41-2.59).

Conclusion

While a family history may aid clinicians in identifying high-risk individuals, literature has long suggested the importance of gene-environment interaction. This review identified several modifiable factors including medical treatments, indoor and outdoor environmental exposure, and personal and family lifestyle specific to Asia. Based on the meta-analyses performed, prevention strategies against AD may start from changing personal and family lifestyle choices, especially smoking habits.

An exploratory randomized controlled trial comparing wood-composite and synthetic fibreglass splint systems for the immobilization of paediatric upper limb fractures

AIMS

This exploratory randomized controlled trial (RCT) aimed to determine the splint-related outcomes when using the novel biodegradable wood-composite splint (Woodcast) compared to standard synthetic fibreglass (Dynacast) for the immobilization of undisplaced upper limb fractures in children.

METHODS

An exploratory RCT was performed at a tertiary paediatric referral hospital between 1 June 2018 and 30 September 2019. The intention-to-treat population consisted of 170 patients (mean age 8.42 years (SD 3.42); Woodcast (WCG), n = 84, 57 male (67.9%); Dynacast (DNG), n = 86, 58 male (67.4%)). Patients with undisplaced upper limb fractures were randomly assigned to WCG or DNG treatment groups. Primary outcome was the stress stability of the splint material, defined as absence of any deformations or fractures within the splint during study period. Secondary outcomes included patient satisfaction and medical staff opinion. Additionally, biomechanical and chemical analysis of the splint samples was carried out.

RESULTS

Of the initial 170 patients, 168 (98.8%) completed at least one follow-up, and were included for analysis of the primary endpoint. Both treatment groups were well-matched regarding to age, sex, and type and localization of the fracture. Splint breakage occurred in three patients (3.6%; 95% confidence interval (CI), 0.007% to 0.102%) in the WCG and in three children (3.5%, 95% CI 0.007% to 0.09%) in the DNG (p > 0.99). The incidence of splint-related adverse events did not differ between the WCG (n = 21; 25.0%) and DNG (n = 24; 27.9%; p = 0.720). Under experimental conditions, the maximal tensile strength of Dynacast samples was higher than those deriving from Woodcast (mean 15.37 N/mm² (SD 1.37) vs 10.75 N/mm² (SD 1.20); p = 0.002). Chemical analysis revealed detection of polyisocyanate-prepolymer in Dynacast and polyester in Woodcast samples.

CONCLUSION

Splint-related adverse events appear similar between WCG and DNG treatment groups during the treatment of undisplaced forearm fractures. Cite this article: Bone Joint J 2020;102-B(10):1405-1411.

Isocyanate emissions from pyrolysis of mattresses containing polyurethane foam

This study examined the emissions of powerful asthmatic agents called isocyanates from small-scale pyrolysis experiments of two common foams employed in mattress production such as flexible polyurethane foam (FPUF) and viscoelastic memory foam (VMF). A nitrogen atmosphere and five different temperatures, 300, 350, 400, 450 and 850 °C, were selected to carry out the experiments in order to evaluate the worst possible conditions for thermal degradation. A similar trend for both materials was found. At lower temperatures, diisocyanates were the most important products whereas at 850 °C monoisocyanates, and mainly isocyanic acid released mainly from the thermal cracking of diisocyanates evolved directly from the polymer chains. The total yields of isocyanates were in the range of 1.43-11.95 mg/m³ for FPUF at 300-850 °C and 0.05-6.13 mg/m³ for VMF, 300-850 °C. This difference could be a consequence of the lower amount of isocyanates employed in the VMF production which was confirmed by the nitrogen content of the foams, 5.95% FPUF vs. 3.34% in VMF. Additionally, a qualitative search for so far unknown isocyanates was performed in samples from the pyrolysis of FPUF at 300, 400 and 850 °C. It was confirmed that six different aminoisocyanates at 300 °C were evolved, whereas at 400 and 850 °C only five of them were detected. The general trend observed was a decrease of the aminoisocyanate levels with increasing pyrolysis temperature.

Residual Isocyanates in Medical Devices and Products: A Qualitative and Quantitative Assessment

We conducted a pilot qualitative and quantitative assessment of residual isocyanates and their potential initial exposures in neonates, as little is known about their contact effect. After a neonatal intensive care unit (NICU) stockroom inventory, polyurethane (PU) and PU foam (PUF) devices and products were qualitatively evaluated for residual isocyanates using Surface SWYPE™. Those containing isocyanates were quantitatively tested for methylene diphenyl diisocyanate (MDI) species, using UPLC-UV-MS/MS method. Ten of 37 products and devices tested, indicated both free and bound residual surface isocyanates; PU/PUF pieces contained aromatic isocyanates; one product contained aliphatic isocyanates. Overall, quantified mean MDI concentrations were low (4,4'-MDI = 0.52 to 140.1 pg/mg) and (2,4'-MDI = 0.01 to 4.48 pg/mg). The 4,4'-MDI species had the highest measured concentration (280 pg/mg). Commonly used medical devices/products contain low, but measurable concentrations of residual isocyanates. Quantifying other isocyanate species and neonatal skin exposure to isocyanates from these devices and products requires further investigation.

Determination of albumin adducts of 4,4'-methylenediphenyl diisocyanate after specific inhalative challenge tests in workers

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important isocyanate used in the industry. Lung sensitization with bronchial asthma is the main disorder in exposed workers. Albumin adducts of MDI might be involved in specific immunological reactions. MDI adducts with lysine (MDI-Lys) of albumin have been found in MDI-workers and construction workers. MDI-Lys is an isocyanate-specific adduct of MDI with albumin. In the present study, we report MDI-adducts in workers undergoing diagnostic MDI challenge tests. The workers were exposed for 2h to 5ppb of MDI. The adduct levels increase significantly after the exposure to MDI in the challenge chamber. About 0.6% of the dose was bound to albumin. So far, only urinary metabolites of MDI were measured to monitor isocyanate workers. However, such urinary metabolites are not isocyanate specific. Therefore, we propose to measure albumin adducts for monitoring MDI exposed subjects.

Isocyanates and human health: multistakeholder information needs and research priorities

OBJECTIVES

To outline the knowledge gaps and research priorities identified by a broad base of stakeholders involved in the planning and participation of an international conference and research agenda workshop on isocyanates and human health held in Potomac, Maryland, in April 2013.

METHODS

A multimodal iterative approach was used for data collection including preconference surveys, review of a 2001 consensus conference on isocyanates, oral and poster presentations, focused break-out sessions, panel discussions, and postconference research agenda workshop.

RESULTS

Participants included representatives of consumer and worker health, health professionals, regulatory agencies, academic and industry scientists, labor, and trade associations.

CONCLUSIONS

Recommendations were summarized regarding knowledge gaps and research priorities in the following areas: worker and consumer exposures; toxicology, animal models, and biomarkers; human cancer risk; environmental exposure and monitoring; and respiratory epidemiology and disease, and occupational health surveillance.

Nonoccupational and occupational exposure to isocyanates

PURPOSE OF REVIEW

This review aims to update the knowledge on the burden of disease due to exposure to isocyanates. Health effects of isocyanates and their major products, polyurethanes, are mainly determined by sensitization to isocyanates. Recent studies on the genetic factors to explain individual susceptibility to sensitization are reviewed.

RECENT FINDINGS

Production of isocyanates has rapidly increased in the past and is predicted to increase at an annual rate of around 5%. Consumer products and the construction area are the main drivers of growth. This leads to increased nonoccupational exposure. The use of sprayed polyurethane foams for insulation in existing homes is one such example of nonoccupational exposure. The percentage of people exposed who show health effects is not known. Occupational exposure increases are mainly caused by the increase in the workforce. The percentage of workers exhibiting health effects remained fairly stable at 5-15% in the last decade. To explain why not all people exposed to isocyanates develop adverse health effects, recent findings on sensitization to isocyanate are reviewed. The skin is the most important route for sensitization.

SUMMARY

Increased production of isocyanates and rising use of these substances in consumer products is leading to an increased burden of disease, with an increase in nonoccupational exposure as well. Sensitization to isocyanates is the main route for adverse health effects. The skin is the major route for sensitization. Recently, several genetic factors have been identified that play a role in the individual susceptibility for sensitization.

Isocyanate exposure assessment combining industrial hygiene methods with biomonitoring for end users of orthopedic casting products

Previous studies have suggested a potential risk to healthcare workers applying isocyanate-containing casts, but the authors reached their conclusions based on immunological or clinical pulmonology test results alone. We designed a study to assess potential exposure to methylene diphenyl diisocyanate (MDI) among medical personnel applying orthopedic casts using two different application methods. Air, dermal, surface, and glove permeation sampling methods were combined with urinary biomonitoring to assess the overall risk of occupational asthma to workers handling these materials. No MDI was detected in any of the personal and area air samples obtained. No glove permeation of MDI was detected. A small proportion of surface (3/45) and dermal wipe (1/60) samples were positive for MDI, but were all from inexperienced technicians. Urinary metabolites of MDI [methylenedianiline (MDA)] were detected in three of six study participants prior to both a 'dry' and 'wet' application method, five of six after the dry method, and three of six after the wet method. All MDA results were below levels noted in worker or general populations. Our conclusion is that the risk of MDI exposure is small, but unquantifiable. Because there is some potential risk of dermal exposure, medical personnel are instructed to wear a minimum of 5-mil-thick (5 mil = 0.005 inches) nitrile gloves and avoid contact to unprotected skin. This could include gauntlets, long sleeves, and/or a laboratory coat.

Synthetic approaches to obtain amino acid adducts of 4,4'-methylenediphenyl diisocyanate

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important isocyanate used in the chemical industry. Lung sensitization and asthma are the main types of damage after exposure to MDI. Albumin adducts of MDI might be involved in the etiology of sensitization reactions. It is therefore necessary to have sensitive and specific biomarkers such as blood protein adducts to monitor people exposed to isocyanates. For the discovery of new isocyanate adducts with blood proteins present in vivo, new synthetic standards are needed. To achieve this, we developed five methods to obtain amino acid adducts of MDI. We synthesized and isolated MDI adducts of aspartic acid, glutamic acid, cysteine, and valine. The new adducts were characterized by LC-MS/MS and NMR. We synthesized the corresponding isotope-labeled MDI adducts to develop analytical methods using LC-MS/MS. Glutathione adducts of isocyanates are an important way of transportation of the reactive isocyanates to distant sites from the original site of exposure. Therefore, we used N-acetyl-cysteine adducts of MDI as reactants: N-acetyl-S-[[4-(4-aminobenzyl)phenyl]carbamoyl]-cysteine (MDI-AcCys) and N-acetyl-S-[[4-(4-acetylaminobenzyl)phenyl]carbamoyl]-cysteine (AcMDI-AcCys). MDI-AcCys or AcMDI-AcCys formed adducts with albumin, N(α)-acetyl lysine, and valine. Isotope-labeled albumin adducts (= d(4)-MDI-albumin) were synthesized from d(4)-MDI-AcCys and albumin. d(4)-MDI-albumin can be used as an internal standard to analyze biological samples. Such an internal standard will not correct only for the extraction recovery of the adducts but also for the potential variation of the enzymatic digestions used in the procedure to analyze albumin adducts of MDI. The synthetic procedures described in this manuscript will be applicable to the synthesis of amino acid adducts from other isocyanates.

Determination of isocyanate specific albumin-adducts in workers exposed to toluene diisocyanates

Toluene diisocyanates (2,4-TDI and 2,6-TDI) are important intermediates in the chemical industry. Among the main damages after low levels of TDI exposure are lung sensitization and asthma. It is therefore necessary to have sensitive and specific methods to monitor isocyanate exposure of workers. Urinary metabolites or protein adducts have been used as biomarkers in workers exposed to TDI. However, with these methods it was not possible to determine if the biomarkers result from exposure to TDI or to the corresponding toluene diamines (TDA). This work presents a new procedure for the determination of isocyanate-specific albumin adducts. Isotope dilution mass spectrometry was used to measure the adducts in albumin present in workers exposed to TDI. 2,4-TDI and 2,6-TDI formed adducts with lysine: N(ϵ)-[({3-amino-4-methylphenyl}amino)carbonyl]-lysine, N(ϵ)-[({5-amino-2-methylphenyl}amino)carbonyl]-lysine, and N(ϵ)- [({3-amino-2-methylphenyl}amino)carbonyl]-lysine. In future studies, this new method can be applied to measure TDI-exposures in workers.

Transferability of aliphatic isocyanates from recently applied paints to the skin of auto body shop workers

Isocyanates, the essential cross-linking chemicals used to make polyurethane, are potent sensitizers and a common cause of occupational asthma. In addition, isocyanate (NCO) skin contact may contribute to the development of isocyanate asthma. Prior work has shown that unbound NCO can persist on recently spray coated auto body parts after appearing dry. The purpose of this study was to assess whether isocyanate skin exposure can result from handling such surfaces. Quantitative surface and skin wipe sampling for total NCO was performed on test panels sprayed with aliphatic isocyanate coatings, and on paired skin samples obtained from participants who had rubbed the recently dried surfaces. Surface and skin samples, obtained from 18 workers in five auto body shops, were prepared following NIOSH method 5525 (modified for skin samples), and isocyanate species derived from hexamethylene diisocyanate and isophorone diisocyanate were analyzed using high-performance liquid chromatography with ultraviolet and fluorescence detectors. Quantifiable unbound NCO species were detected on 84.2% of all sprayed surfaces sampled after initially considered dry. Only 7 out of a total of 104 (6.7%) non-compounded skin samples obtained after contact with the recently dried coatings had detectable quantities of free NCO. The 7 positive samples, all obtained at the initial sampling time (t(0)), had a geometric mean of 0.016 μg NCO cm(-2) (range: 0.002-0.88 μg NCO cm(-2)). Only 1 of 12 (8.3%) of skin samples obtained after compounding contained detectable free NCO. The risk of substantial human isocyanate skin exposure from contact with the dry appearing (yet not fully cured) isocyanate coatings evaluated in this study appears to be low, although other isocyanate coatings and tasks may pose a greater risk of NCO skin exposure.

Polyurethane toilet seat contact dermatitis

Polyurethane chemicals are produced by the reaction of isocyanates and they may cause allergic contact dermatitis or precipitate asthma attacks. Contact dermatitis to polyurethane toilet seat has not been reported before. Herein we present a case of allergic contact dermatitis to polyurethane toilet seat.

Determination of a new biomarker in subjects exposed to 4,4'-methylenediphenyl diisocyanate

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important of the isocyanates used as intermediates in the chemical industry. Among the main types of damage after exposure to low levels of MDI are lung sensitization and asthma. Albumin adducts of MDI might be involved in the etiology of sensitization reactions. This work presents a liquid chromatography (LC)-mass spectrometry (MS/MS) procedure for determination of isocyanate-specific albumin adducts in humans. MDI formed adducts with lysine of albumin: MDI-Lys and AcMDI-Lys. The MDI-Lys levels, 25th, 50th, 75th, 90th percentile, were 0, 65.2, 134, 244 fmol mg(-1) and 0, 30.5, 57.4, 95.8 fmol mg(-1) in the exposed construction and factory workers, respectively. This new biomonitoring procedure will allow assessment of suspected exposure sources and may contribute to the identification of individuals who are particularly vulnerable for developing bronchial asthma and other respiratory diseases after exposure to isocyanates.

New isocyanate-specific albumin adducts of 4,4'-methylenediphenyl diisocyanate (MDI) in rats

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important of the isocyanates used as intermediates in the chemical industry. Among the main types of damage after exposure to low levels of MDI are lung sensitization and asthma. Albumin adducts of MDI might be involved in the etiology of sensitization reactions. It is, therefore, necessary to have sensitive and specific methods for monitoring the isocyanate exposure of workers. To date, urinary metabolites or protein adducts have been used as biomarkers in workers exposed to MDI. However, with these methods it is not possible to determine whether the biomarkers result from exposure to MDI or to the parent aromatic amine 4,4'-methylenedianiline (MDA). This work presents a procedure for the determination of isocyanate-specific albumin adducts. In a long-term experiment, designed to determine the carcinogenic and toxic effects of MDI, rats were exposed chronically for 3 months, to 0.0 (control), 0.26, 0.70, and 2.06 mg MDI/m(3) as aerosols. Albumin was isolated from plasma, digested with Pronase E, and analyzed by LC-MS/MS. MDI formed adducts with lysine: N(6)-[({4-[4-aminobenzyl]phenyl}amino)carbonyl]lysine (MDI-Lys) and N(6)-[({4-[4-(acetylamino)benzyl]phenyl}amino)carbonyl] lysine (AcMDI-Lys). For the quantitation of the adducts in vivo, isotope dilution mass spectrometry was used to measure the adducts in 2 mg of albumin. The adducts found in vivo (MDI-Lys and AcMDI-Lys) and the corresponding isotope labeled compounds (MDI-[(13)C(6)(15)N(2)]Lys and Ac[(2)H(4)]MDI-Lys) were synthesized and used for quantitation. The MDI-Lys levels increased from 0-24.8 pmol/mg albumin, and the AcMDI-Lys levels increased from 0-1.85 pmol/mg albumin. The mean ratio of MDI-Lys/AcMDI-Lys for each dose level was greater than >20. The albumin adducts correlate with other biomarkers measured in the same rats in the past: urinary metabolites and hemoglobin adducts released after mild base hydrolysis. This method will enable one to measure isocyanate-specific albumin adducts in workers. This new biomonitoring procedure will allow for the assessment of suspected exposure sources and may contribute to the identification of individuals who are particularly vulnerable for developing bronchial asthma and other respiratory diseases after exposure to isocyanates. In addition, it will help to improve the production of antigens for the analysis of antibodies in exposed workers.

Determination of isocyanate biomarkers in construction site workers

4,4'-Methylenediphenyl diisocyanate (MDI) is the most important isocyanate in the manufacture of polyurethanes, dyes, pigments and adhesives. High concentrations of isocyanates are a potent respiratory irritant. Therefore, it is important to develop methods to monitor exposure to such compounds. We monitored biological samples from 40 non-exposed and 45 exposed construction site workers. 4,4'-Methylenedianiline (MDA) and N-acetyl-4,4'-MDA (AcMDA) were determined from untreated urine (U-MDA, U-AcMDA) and MDA was analysed from acid-treated urine (U-MDA-tot). Haemoglobin (Hb) adducts of MDA (Hb-MDA) were determined in all workers. The levels of biomarkers decreased in the following order: U-MDA-tot>U-AcMDA>U-MDA>Hb-MDA. The same order was found for the percentage of samples, which were found positive in exposed workers: 100%, 91%, 91%, 27%. The urine levels U-MDA-tot correlate with U-MDA, U-AcMDA and Hb-MDA with r=0.79, 0.86 and 0.39, respectively (Spearman rank order, p<0.01). U-AcMDA correlates with U-MDA and Hb-MDA with r=0.77 and 0.47, respectively (p<0.01). U-MDA correlates with Hb-MDA (r=0.38, p<0.05). The levels in the controls were significantly lower than in the exposed workers for all compounds (Mann-Whitney test, p<0.01). The median isocyanate-specific IgE-level was higher in the exposed workers, but the difference was statistically not significant. The change of the biomarker levels was compared in a group of workers (n=20), which were analysed prior to isocyanate exposure and after the exposure for approximately 4-7 months. All urine MDA metabolites and the Hb-adduct levels increased significantly (Wilcoxon sign test, p<0.01). Total IgE increased significantly after the exposure with isocyanate activity (p<0.01). With the present work it could be shown that outdoor workers are exposed to a similar extent as workers from a MDI factory.

A survey of airborne and skin exposures to chemicals in footwear and equipment factories in Thailand

This research reports on a pilot industrial hygiene study that was performed at four footwear factories and two equipment factories in Thailand. Workers in these factories were exposed through inhalation and dermal contact to a large number of organic vapors from solvents and cements that were hand applied. In addition, these workers were exposed to highly toxic isocyanates primarily through the dermal route. A total of 286 personal air samples were obtained at the four footwear factories using organic vapor monitors; individual job tasks were monitored using a real-time MIRAN Spectrometer. A total of 64 surface, tool, or hand samples were monitored for isocyanates using surface contamination detectors. Real-time measurements were also obtained for organic vapors in two equipment factories. From 8% to 21% of the workers sampled in each footwear factory were overexposed to mixtures of chemicals from solvents and cements. Up to 100% of the workers performing specific job tasks were overexposed to mixtures of chemicals. From 39% to 69% of the surface samples were positive for unreacted isocyanates. Many of the real-time measurements obtained in the equipment factories exceeded occupational exposure limits. Personal protective equipment and engineering controls were inadequate in all of the factories.

Symptoms of asthma and atopic disorders in preschool children: prevalence and risk factors

BACKGROUND

Published epidemiological data suggested that asthma and allergies may be increasing in preschool children. Identification of the risk factors is important for planning possible early intervention to prevent asthma. This study was designed to measure the prevalence of, and risk factors for, asthma and atopic disorders in preschool children from Hong Kong.

METHODS

Children aged 2-6 years living in Hong Kong were recruited through the local nurseries and kindergartens for this study to ascertain the presence of symptoms of asthma and various possible risk factors. The parental questionnaire was developed based on the International Study of Asthma and Allergies in Childhood questionnaire.

RESULTS

A total of 3089 children (1506 boys) from 14 nurseries and kindergartens participated in this study. The prevalence of wheeze ever and current wheeze were 16.7% and 9.3%. Two hundred and thirty-four subjects were born in mainland China and migrated to Hong Kong subsequently. When compared with children born and raised in Hong Kong, children born in mainland China had significantly lower prevalence of current wheeze (3.4% vs. 9.6%, P<0.01). Two environmental factors in the first year of life were associated with wheezing attacks within the last 12 months. They were the use of foam pillow (Odds ratio: 1.45; 95% Confidence interval: 1.04-2.00) and the use of gas as cooking fuel (1.68; 1.03-2.75). Frequent use of paracetamol was also associated with wheezing attack in the past 12 months.

CONCLUSIONS

This study confirms the high prevalence of symptoms of atopic disorders in preschool children from Hong Kong. Early environmental exposure factors are important determinants of subsequent development of asthma symptoms in the preschool years. Further studies are needed to evaluate the possible pathogenetic role of the identified risk factors.

Skin exposure to isocyanates: reasons for concern

OBJECTIVE

Isocyanates (di- and poly-), important chemicals used worldwide to produce polyurethane products, are a leading cause of occupational asthma. Respiratory exposures have been reduced through improved hygiene controls and the use of less-volatile isocyanates. Yet isocyanate asthma continues to occur, not uncommonly in settings with minimal inhalation exposure but opportunity for skin exposure. In this review we evaluate the potential role of skin exposure in the development of isocyanate asthma.

DATA SOURCES

We reviewed the published animal and human literature on isocyanate skin-exposure methods, workplace skin exposure, skin absorption, and the role of skin exposure in isocyanate sensitization and asthma.

DATA EXTRACTION

We selected relevant articles from computerized searches on Medline, U.S. Environmental Protection Agency, Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, and Google databases using the keywords "isocyanate," "asthma," "skin," "sensitization," and other synonymous terms, and our own extensive collection of isocyanate publications.

DATA SYNTHESIS

Isocyanate production and use continues to increase as the polyurethane industry expands. There is substantial opportunity for isocyanate skin exposure in many work settings, but such exposure is challenging to quantify and continues to be underappreciated. Isocyanate skin exposure can occur at work, even with the use of personal protective equipment, and may also occur with consumer use of certain isocyanate products. In animals, isocyanate skin exposure is an efficient route to induce sensitization, with subsequent inhalation challenge resulting in asthma-like responses. Several lines of evidence support a similar role for human isocyanate skin exposure, namely, that such exposure occurs and can contribute to the development of isocyanate asthma in certain settings, presumably by inducing systemic sensitization.

CONCLUSIONS

Integrated animal and human research is needed to better understand the role of skin exposure in human isocyanate asthma and to improve diagnosis and prevention. In spite of substantial research needs, sufficient evidence already exists to justify greater emphasis on the potential risks of isocyanate skin exposure and the importance of preventing such exposures at work and during consumer use of certain isocyanate products.

Determination of airborne isocyanates

Isocyanates are important in industrial hygiene and workplace monitoring. Owing to their severe acute toxicity and sensitizing properties, analytical methods with high sampling efficiency and sensitivity in the low ppb to ppt range are required. The reactivity of isocyanates necessitates initial derivatization with nucleophilic agents--usually amines--for stabilization and enrichment; this is often followed by chromatographic separation with spectroscopic, electrochemical, or mass spectrometric detection. Sampling strategies for airborne isocyanates comprise active, i.e. pumped, or passive, i.e. diffusive, methods; the method selected depends on the application. Whereas active methods rely mainly on impingers, reagent-coated filters, or sampling tubes, passive samplers make use of reagent-coated filters, the surface of which is connected to the air sample by diffusion channels. Because airborne isocyanates are prone to occur in different forms, i.e. as vapors, as aerosols, or adsorbed on particulate matter, denuder sampling has been introduced, thus enabling simultaneous collection of gaseous and aerosol isocyanates. The first part of this review summarizes chemical methods and reagents which have been introduced for derivatization of airborne isocyanates. The advantages and drawbacks of the individual derivatization procedures and their combination with different detection principles are evaluated. In the second part, the most recent developments in air sampling for isocyanates, with special focus on diffusive sampling, are reviewed and critically discussed.

Validation of a diffusive sampling method for airborne low-molecular isocyanates using 4-nitro-7-piperazinobenzo-2-oxa-1,3-diazole-impregnated filters and liquid chromatography–tandem mass spectrometry

A diffusive sampling method for the determination of low-molecular isocyanates as their 4-nitro-7-piperazinobenzo-2-oxa-1,3-diazole (NBDPZ) derivatives using tandem mass spectrometry (MS/MS) after atmospheric pressure chemical ionisation (APCI) is presented. Isocyanic acid (ICA), methyl isocyanate (MIC), ethyl isocyanate (EIC) and phenyl isocyanate (PhIC) are collected on NBDPZ-impregnated polystyrene divinyl benzene (SDB) filter tapes. The method was validated for MIC, EIC and PhIC for concentrations between 0.5 and 50 ppb at relative humidity (RH) conditions from 10 up to 90%. Validation was carried out by active sampling using 1-(2-methoxyphenyl)piperazine (2-MP) as derivatising agent. Sampling periods applied were between 15 min and more than 8 h. The sampling rates were determined to be 21.0 mL/min for MIC with a relative standard deviation (RSD) of 9.0% for 184 samplers, 15.6 mL/min for EIC (RSD 11.6%; N = 154) and 11.5 mL/min for PhIC (RSD 8.4%; N = 87). The limits of quantification were 1.4 ppb for MIC and 1.3 ppb for EIC and PhIC applying 15 min sampling periods. Owing to high background signals, isocyanic acid could only be determined when it was present in concentrations in the high ppb range.