Indexed on: 04 Aug '18Published on: 04 Aug '18Published in: The Journal of Allergy and Clinical Immunology: In Practice
Two-component epoxy resin systems (ERS) composed of epoxy resin and polyamine hardeners are extensively used in industrial and construction coating. Triglycidyl isocyanurate (TGIC) is another type of epoxy derivative, mostly encountered in polyester powder paints. Epoxy compounds are well known skin sensitizers, but their respiratory sensitizing potential is largely unknown. We report patients examined for occupational asthma from epoxy compounds. We retrospectively reviewed patient files of cases tested with a placebo-controlled specific inhalation challenge (SIC) according to their workplace exposure: either by mixing epoxy resin and the polyamine hardener of a two-component paint or by dusting or heating TGIC-containing powder paint. The data were collected from the Finnish Institute of Occupational Health and at the Fundación Jiménez Díaz Hospital, Spain, in 1997-2018. We also measured airborne polyamine and solvent vapours at the workplace and during SIC with ERS. Altogether 113 patients with work-related asthma symptoms underwent SIC with ERS. Fifteen cases (13%) had positive SIC reactions confirming occupational asthma; in 12 cases reactions were late type, in one case early and in two cases combined. The median duration of exposure of occupational asthma patients was ten years, two of them (13%) had a diagnosis of allergic contact dermatitis from ERS compounds. In addition, three cases had a positive SIC reaction to TGIC. The airborne polyamine levels measured were low. ERS and TGIC can cause sensitizer-induced occupational asthma in some exposed workers. Respiratory exposure to ERS is difficult to demonstrate using air measurements. Copyright © 2018. Published by Elsevier Inc.