Occupational Asthma due to Styrene and Toluene Diisocyanate

Abstract

Styrene, a common solvent and volatile organic compound (VOC), is widely used in the factories of plastics, resins, insulators, coatings, and paints. While toluene diisocyanate (TDI) is a well-known causative agent of asthma, styrene has been rarely reported to cause occupational asthma (OA). We report a 50-year-old repairman with OA due to both styrene and TDI in whose job was filling cracks and flattening the surface of vehicles with styrene-containing plaster’s putty, followed by spray painting. He suffered from cough, dyspnea durings the work with putty. Hepresented with a 2-year history of asthma and allergic rhinitis. The level of serum total IgE and sputum eosinophils were 2,878 IU/L and 63%, respectively. The methacholine challenge test was positive (PC20 0.59 mg/mL). The bronchoprovacation tests with TDI and styrene showed early and dual responses, respectively. Currently, he is in well- controlled state with the use of a combination of inhaled corticosteroid and long acting beta2-agonist after the avoidance of the causative agents.