Medical Monitoring for Occupational Asthma Among Toluene Diisocyanate Production Workers in the United States

J Occup Environ Med. 2017 Dec;59 Suppl 12(Suppl 12):S13-S21. doi: 10.1097/JOM.0000000000001197.


Objective: The aim of this study was to describe a study of medical monitoring methods and lessons learned in detecting health outcomes in U.S. plants producing toluene diisocyanate (TDI).

Methods: A multidisciplinary team implemented a medical and environmental monitoring program in three TDI plants.

Results: Of 269 eligible workers, 197 (73%) participated and 42 (21%) met symptom and/or lung function criteria that would trigger evaluation for possible asthma over 5 years of data collection. Subsequent evaluation was delayed for most, and a web-based data collection system improved timeliness.

Conclusion: Medical monitoring of TDI workers identified workers triggering further assessment per study protocol. Systems and/or personnel to ensure rapid follow-up are needed to highlight when triggering events represent potential cases of asthma needing further evaluation. Implementation of a research protocol requires resources and oversight beyond an occupational health program.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asthma, Occupational / chemically induced
  • Asthma, Occupational / diagnosis*
  • Chemical Industry
  • Environmental Monitoring
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Occupational Exposure / adverse effects*
  • Population Surveillance / methods*
  • Program Evaluation
  • Referral and Consultation
  • Spirometry
  • Surveys and Questionnaires
  • Symptom Assessment
  • Toluene 2,4-Diisocyanate / adverse effects*
  • United States
  • Young Adult


  • Toluene 2,4-Diisocyanate