Phthalic anhydride-induced occupational asthma.

Out of 118 workers exposed to phthalic anhydride (PA) dust for 2 months or more in four plants producing alkyd and/or polyunsaturated polyester resins, 28 (24%) suffered from work-related rhinitis, 13 (11%) from chronic productive bronchitis, and 21 (28%) from work-associated asthma. Asthma was generally preceded by rhinitis and was mostly of late type. 3 out of 11 asthmatics had a PA-positive skin test. In 2 subjects the presence of antibodies was demonstrated by the Prausnitz-Küstner test. 4 out of 25 heavily exposed subjects without asthma had a nonspecific bronchial hyperreactivity. The results did not indicate any significant 'healthy worker selection' as regarding rhinits and asthma. Chronic productive bronchitis was common and was more prevalent among former workers than among present employees, indicating a selection of nonreacting subjects in the plant. The time-weighted average breathing zone PA levels in two plants were between 3 and 13 mg/m3 during different direct PA handling operations and less than 0.3 mg/m3 at other kinds of work. In 2 subjects, positive bronchial provocation was obtained by short-term exposure to 0.5 and 6 mg PA/m3, respectively.