Occupational Asthma Due to Toluene Diisocyanate Among Velcro‐Like Tape Manufacturers

During September‐November, 1985, four employees of a factory were seen at the occupational clinic complaining of cough, shortness of breath, and wheezing. All four worked in the same area of the factory where an adhesive containing toluene diisocyanate (TDI) was applied to velcro‐like tape during manufacturing. To confirm the diagnosis of TDI‐induced asthma and determine the prevalence among workers, 38 workers were interviewed and examined (84%) in the factory. Air samples were also taken from several areas in the factory to determine the TDI concentration. For analysis, the factory was divided into three areas based on the concentration of TDI: low (0.012 ± 0.002 ppm), medium (0.021 ± 0.006 ppm), and high (0.047 ± 0.054 ppm). The distribution of workers with symptoms of asthmatic bronchitis was highly associated with TDI concentration (p < 0.001). After stopping work for a period of 10 days, workers in areas with a high concentration of TDI showed marked improvement in pulmonary function tests (PFTs). After isolation of the exposure site, improvement of the ventilation system, and substitution of the TDI with less volatile diphenylmethane diisocyanate (MDI), air concentration of isocyanates was usually below 0.007 ppm. Three of the four clinically overt asthma cases went back to work without any difficulty. The PFTs of affected workers showed a significant improvement 5 months later. We conclude that TDI was responsible for the occupational asthma among velcro‐like tape manufacturers and that the TDI‐induced impairment of pulmonary functions was at least partially reversible.