Mortality among workers exposed to toluene diisocyanate in the US polyurethane foam industry: Update and exposure-response analyses

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BackgroundMortality among 4,545 toluene diisocyante (TDI)-exposed workers was updated through 2011. The primary outcome of interest was lung cancer.MethodsLife table analyses, including internal analyses by exposure duration and cumulative TDI exposure, were conducted.ResultsCompared with the US population, all cause and all cancer mortality was increased. Lung cancer mortality was increased but was not associated with exposure duration or cumulative TDI exposure. In post hoc analyses, lung cancer mortality was associated with employment duration in finishing jobs, but not in finishing jobs involving cutting polyurethane foam.ConclusionsDermal exposure, in contrast to inhalational exposure, to TDI is expected to be greater in finishing jobs and may play a role in the observed increase in lung cancer mortality. Limitations include the lack of smoking data, uncertainty in the exposure estimates, and exposure estimates that reflected inhalational exposure only. Am. J. Ind. Med. 59:630–643, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA

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