Pulmonary Toxicity among Car Spray Painters By

Associations between isocyanate exposure and respiratory health effects have received little attention despite the extensive use of isocyanate compounds. Spray painters comprise a large population at risk, with potentially high isocyanate exposure because most lacquers contain hexamethylene diisocyanate. Repeated pulmonary function testing is not sufficient to diagnose and evaluate pulmonary toxicity induced by car paint sprays. Therefore, Clara cell secretory protein (CC16) was selected as a sensitive marker of bronchial tree injury. The present study involved 50 workers exposed to isocyanates during car spray-painting; in addition to 30 control subjects, (20 smokers and 10 non-smokers) who were never exposed to isocyanates. All participants were subjected to pulmonary function testing (FVC, FEV1, FEV1%, and PEFR), bronchoscopy and lavage, and serum CC16 estimation. Different pulmonary function indices as well as CC16 serum levels were found to be significantly decreased in the exposed group. Smokers showed significant reduction in CC16 serum levels. Clara cells were markedly damaged in the exposed subjects, whereas smokers exhibited excessive epithelial cell desquamation. In conclusion, clear associations between lung function parameters, CC16 serum levels, and exposure to isocyanatecontaining paint-sprays were demonstrated. This stresses the importance of regulation and control of such exposure. Also, assay of serum CC16 could be used to detect pulmonary toxic effects in subjects exposed to isocyanate compounds.