背景:异氰酸酯用作聚氨酯(PU)产品的起始材料。它们是相对重要的职业皮肤致敏剂。
目的:分析19种异氰酸酯测试物质和4,4'-二氨基二苯基甲烷(MDA)的大型异氰酸酯贴片测试系列的结果,4,4'-二苯基甲烷二异氰酸酯(MDI)超敏反应的标志。
方法:筛选异氰酸酯系列中的阳性反应的测试文件。对有阳性反应的患者进行职业分析,暴露和诊断。
结果:在2010-2019年,该系列中有53例患者出现阳性反应(338例患者中有16%接受测试)。MDA,公认的MDI过敏筛选物质,30例患者呈阳性,23名患者的内部单体MDI测试物质和19-21名患者的3种不同的聚合MDI测试物质。我们从MDI中诊断出16例职业性过敏性接触性皮炎(OACD),其中包括3例管道修复者。油漆硬化剂中六亚甲基-1,6-二异氰酸酯(HDI)低聚物引起5例OACD,2,4-甲苯二异氰酸酯(TDI;n=3)和异佛尔酮二异氰酸酯(IPDI;n=1)加在一起的情况更多。
结论:与以前的研究相比,聚合MDI测试物质并不优于单体MDI。在PU管道涂料的固化剂中,不仅会受到环氧产品和丙烯酸酯的影响,还会受到MDI的影响。HDI低聚物是仅次于MDI的第二重要OACD原因。
BACKGROUND: Isocyanates are used as starting materials of polyurethane (PU) products. They are relatively important occupational skin sensitizers.
OBJECTIVE: To analyse results of a large isocyanate patch test series of 19 isocyanate test substances and 4,4\'-diaminodiphenylmethane (MDA), a marker of 4,4\'-diphenylmethane diisocyanate (MDI) hypersensitivity.
METHODS: Test files were screened for positive reactions in the isocyanate series. Patients with positive reactions were analysed for occupation, exposure and diagnosis.
RESULTS: In 2010-2019, 53 patients had positive reactions in the series (16% of 338 patients tested). MDA, the well-established screening substance for MDI allergy, was positive in 30 patients, an in-house monomeric MDI test substance in 23 patients and 3 different polymeric MDI test substances in 19-21 patients. We diagnosed 16 cases of occupational allergic contact dermatitis (OACD) from MDI including 3 pipe reliners. Hexamethylene-1,6-diisocyanate (HDI) oligomers in paint hardeners caused 5 cases of OACD, more cases than 2,4-toluene diisocyanate (TDI; n = 3) and isophorone diisocyanate (IPDI; n = 1) put together.
CONCLUSIONS: In contrast to previous studies, polymeric MDI test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised not only by epoxy products and acrylates but also by MDI in hardeners of PU pipe coatings. HDI oligomers were the second most important causes of OACD after MDI.