OCCUPATIONAL ASTHMA CAUSED BY LOW-MOLECULAR WEIGHT CHEMICAL AGENTS

[摘要] Maccia and co-workers [1976] described the occurrence of asthma in a worker exposed to phthalic anhydride(PA), an important chemical in the manufacture of plasticizers, epoxy resin and patients. Trimellitic anhydride(TMA) is a low MW compound differing from PA only by an additional carboxyl group. TMA, like PA, is used as a plasticizer, as a curing agent, and in alkyl resins used in surface coatings. Zeiss and his colleagues [1977] reported a spectrum of respiratory disease caused by TMA. Fourteen workers in a plant synthesizing TMA were studied retrospectively. Clinical findings included rhinitis, early- and late-onset asthama and airway irritation. Occasionally systemic symptoms were also seen. Examination of the chemical plant showed that TMA could be inhaled either as fumes or dust and that workers were intermittently exposed. Three distinct syndromes could be described from clinical histories: rhinitis and/or asthma development after a latent period of weeks or years, late-onset cough and wheezing dyspnea occurring after a latent period of exposure, termed TMA flu, and an irritant effect requiring no latent period, and occurring on first heavy exposure to TMA fumes, characterized by rhinorrhea, occasional epistaxis, cough, dyspnea and wheezing. Immunologic tests were done. This current report of yet another industrial chemical capable of inducing asthma, stresses the importance of considering the patient''s accupational history when evaluating his disease. Asthma of occupational origin is asubstantial cause of respiratory disease.