Original Articles
3 April 2025
Vol. 38 No. 2 (2016)
Upper airway and eye involvement in polyurethane shoe sole production workers
[Sintomi delle vie aeree superiori e delle congiuntive nei lavoratori addetti alla produzione di suole in poliuretano per calzature*
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Objectives: This cross-sectional study was aimed to investigate the prevalence of work-related upper and lower airway and eye symptoms in 118 workers in polyurethane shoe soles (PSS) production. Methods: Workplace monitoring of methylene diphenyl disocyanate (MDI) and solvents was performed. Subjects completed a study-specific questionnaire and underwent anterior rhinoscopy, skin prick tests for common aeroallergens, spirometry, nasal peak inspiratory (NPIF) and expiratory flow (NPEF).
Results: MDI and solvent levels were below threshold limit value-time-weighted average (TLW-TWA) except for two measures of dichloromethane and tetrachloroethylene, respectively, and in one measure of acetonitrile, which were higher then TLW-TWA. In exposed workers the prevalence of cough (p<0.05) and nasal congestion at rhinoscopy (p= 0.05) was more frequent than in non-exposed workers. Occupational exposure (OR 4.5, 95% CI 1.2-16.5) and a low FEV, (OR 2.6, 95% CI 1.1-6.3) were significant predictors of cough. Conclusions: In workers exposed to low levels of MDI and solvents in polyurethane shoe sole production there was a high prevalence of cough and nasal congestion. An improvement in the exhaust ventilation system and other preventive measures were needed.
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Citations
1) American Thoracic Society. Standardization of spirometry, 1987 update. Am Rev Respir Dis 1987; 136: 1285-1298.
2) Andrew G, Tobias J, Stehley P. Surfactant technology for low density molded microcellular and flexible polyurethane systems. PU Latin America 2001;Technical Update 4, Footwear and CASE Paper 8, 2001: 1-6.
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4) Bernstein JA. Overview of diisocyanate occupational asthma Toxicology 1996; 111: 181-189.
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6) Cocheo V, Boaretto C, Sacco P. High uptake rate radial diffusive sampler suitable for both solvents and thermal desorption. Am Ind Hyg Assoc J 1996; 57: 897-904.
7) Farley JW, Durham LH, ElI SR. Correlation of subjective sensation of nasal patency with nasal inspiratory peak flow rate. Clin Otolaryngol 1993; 18: 19-22.
8) Gautrin D, Bernstein IL, Brooks SM, Henneberger PK. Reactive airways dysfunction syndrome and irritant-induced asthma. In Bernstein IL, Chan-Yeung M, Malo J-L, Bernstein DI (eds) Asthma in the Workplace. 3rd edn. Taylor & Francis, New York, pp 581-629, 2006. 9) Global Initiative for Chronic Obstructive Lung Disease: National Institutes of Health. National Hearth, Lung, and Blood Institute. Publication Number 2701, 2001.
10) Hempel-Jorgensen A, Kjargaard SK, Molhave L. Cytological changes and conjunctival hyperemia in relation to sensory eye irritation. Int Arch Occup Environ Health 1998; 71: 225-235.
11) Jacobsson K, Kronholm-Diab K, Rylander L, Hagmar L. Airway symptoms and lung function in pipelayers exposed to thermal de gradation products from MDI-based polyurethane. Occup Environ Med 1997; 54: 873-879.
12) Jones AS, Willatt DJ, Durham LM. Nasal airflow: resistance and sensation. J Laryngol Otol 1989; 103: 909-911.
13) Littorin M, Rylander L, Skarping G et al. Exposure biomarkers and risk at gluing and heating of polyurethane - a cross-sectional study of respiratory symptoms. Occup Environ Med 2000; 57: 396-405. 14) Littorin M, Truedsson L, Welinder H et al. Acute respiratory disorder, rhinoconjunctivitis and fever associated with pyrolysis of polyurethane derived from diphenylmethane diisocyanate. Scand J Work Environ Health 1994; 20: 216-222.
15) Meredith SK, Taylor VM, McDonald JC. Occupational respiratory disease in United Kingdom 1989: a report to the British Thoracic Society and the Society of Occupational Medicine in the SWORD project group. Br J Ind Med 1991; 48: 292-298.
16) Miadina R, Cujié E, Subarié M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol 2008; 29: 75-82.
17) Moen BE, Hollund BE. Exposure to organic solvents among car painters in Bergen, Norway. Ann Occup Hyg 2000; 44: 185-189.
1) American Thoracic Society. Standardization of spirometry, 1987 update. Am Rev Respir Dis 1987; 136: 1285-1298. DOI: https://doi.org/10.1164/ajrccm/136.5.1285
2) Andrew G, Tobias J, Stehley P. Surfactant technology for low density molded microcellular and flexible polyurethane systems. PU Latin America 2001;Technical Update 4, Footwear and CASE Paper 8, 2001: 1-6.
3) Bernstein DI, Korbee L, Stauder T et al. The low prevalence of occupational asthma and antibody-dependent sensitization to diphenylmethane disocyanate in a plant engineered for minimal exposure to diisocyanates. J Allergy Clin Immunol 1993; 92: 387-396. DOI: https://doi.org/10.1016/0091-6749(93)90117-X
4) Bernstein JA. Overview of diisocyanate occupational asthma Toxicology 1996; 111: 181-189. DOI: https://doi.org/10.1016/0300-483X(96)03375-6
5) Chia SE, Ong CN, Phoon WH, et al. Neurobehavioural effects on workers in a video tape manufacturing factory in Singapore. Neurotoxicology 1993; 4: 51-56.
6) Cocheo V, Boaretto C, Sacco P. High uptake rate radial diffusive sampler suitable for both solvents and thermal desorption. Am Ind Hyg Assoc J 1996; 57: 897-904. DOI: https://doi.org/10.1202/0002-8894(1996)057<0897:HURRDS>2.0.CO;2
7) Farley JW, Durham LH, ElI SR. Correlation of subjective sensation of nasal patency with nasal inspiratory peak flow rate. Clin Otolaryngol 1993; 18: 19-22. DOI: https://doi.org/10.1111/j.1365-2273.1993.tb00803.x
8) Gautrin D, Bernstein IL, Brooks SM, Henneberger PK. Reactive airways dysfunction syndrome and irritant-induced asthma. In Bernstein IL, Chan-Yeung M, Malo J-L, Bernstein DI (eds) Asthma in the Workplace. 3rd edn. Taylor & Francis, New York, pp 581-629, 2006. 9) Global Initiative for Chronic Obstructive Lung Disease: National Institutes of Health. National Hearth, Lung, and Blood Institute. Publication Number 2701, 2001. DOI: https://doi.org/10.3109/9780849374531-26
10) Hempel-Jorgensen A, Kjargaard SK, Molhave L. Cytological changes and conjunctival hyperemia in relation to sensory eye irritation. Int Arch Occup Environ Health 1998; 71: 225-235. DOI: https://doi.org/10.1007/s004200050274
11) Jacobsson K, Kronholm-Diab K, Rylander L, Hagmar L. Airway symptoms and lung function in pipelayers exposed to thermal de gradation products from MDI-based polyurethane. Occup Environ Med 1997; 54: 873-879. DOI: https://doi.org/10.1136/oem.54.12.873
12) Jones AS, Willatt DJ, Durham LM. Nasal airflow: resistance and sensation. J Laryngol Otol 1989; 103: 909-911. DOI: https://doi.org/10.1017/S0022215100110485
13) Littorin M, Rylander L, Skarping G et al. Exposure biomarkers and risk at gluing and heating of polyurethane - a cross-sectional study of respiratory symptoms. Occup Environ Med 2000; 57: 396-405. 14) Littorin M, Truedsson L, Welinder H et al. Acute respiratory disorder, rhinoconjunctivitis and fever associated with pyrolysis of polyurethane derived from diphenylmethane diisocyanate. Scand J Work Environ Health 1994; 20: 216-222. DOI: https://doi.org/10.5271/sjweh.1405
15) Meredith SK, Taylor VM, McDonald JC. Occupational respiratory disease in United Kingdom 1989: a report to the British Thoracic Society and the Society of Occupational Medicine in the SWORD project group. Br J Ind Med 1991; 48: 292-298. DOI: https://doi.org/10.1136/oem.48.5.292
16) Miadina R, Cujié E, Subarié M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol 2008; 29: 75-82. DOI: https://doi.org/10.1016/j.amjoto.2007.02.002
17) Moen BE, Hollund BE. Exposure to organic solvents among car painters in Bergen, Norway. Ann Occup Hyg 2000; 44: 185-189. DOI: https://doi.org/10.1016/S0003-4878(99)00092-7
How to Cite
Upper airway and eye involvement in polyurethane shoe sole production workers: [Sintomi delle vie aeree superiori e delle congiuntive nei lavoratori addetti alla produzione di suole in poliuretano per calzature*. (2025). Giornale Italiano Di Medicina Del Lavoro Ed Ergonomia, 38(2), 89-95. https://doi.org/10.4081/gimle.657
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