Safety and Health at Work Vol. 13 Issue 1 2022
Author’s Response to Letters to the Editor regarding “Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies” (Letter to the Editor)
Dublin Core
Title
Safety and Health at Work Vol. 13 Issue 1 2022
Author’s Response to Letters to the Editor regarding “Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies” (Letter to the Editor)
Author’s Response to Letters to the Editor regarding “Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies” (Letter to the Editor)
Subject
Risk Assesment, Toluene Diisocyanate, Respiraory Disease
Description
To the editor,
In response to the comments of [letter by Osman-Sypher] the
healthy worker survivor effect (HWSE) is now recognized as an
important potential source of bias in occupational disease epidemi-
ology [1,2]. It is particularly troublesome in etiologic studies and
when estimating the exposure response relationship in worker
populations exposed to irritants or experiencing acute adverse
health effects. It occurs when some workers leave employment
(or exposure) sooner than others due to health problems but
similar effects (such as attenuation of exposure response with
increasing cumulative exposure) could result if full ascertainment
and recording of exposure-attributable effects depended on expo-
sure levels, if there were development of tolerance, or if personal
protective equipment (PPE) had been utilized by some employees
but not accounted for in analyses. Toluene diisocyanate (TDI) is
just one of numerous reactive entities that occur in composite poly-
merization systems in manufacturing (e.g., cyanoacrylates, ABS,
epoxy resins). The literature reveals complaint-initiated investiga-
tions of such materials which subsequently report no apparent as-
sociation of respiratory problems with duration and other exposure
measures at current exposure levels, but without accounting for
HWSE or other violations of the assumed model [e.g., Goodman
et al. [3]].
In response to the comments of [letter by Osman-Sypher] the
healthy worker survivor effect (HWSE) is now recognized as an
important potential source of bias in occupational disease epidemi-
ology [1,2]. It is particularly troublesome in etiologic studies and
when estimating the exposure response relationship in worker
populations exposed to irritants or experiencing acute adverse
health effects. It occurs when some workers leave employment
(or exposure) sooner than others due to health problems but
similar effects (such as attenuation of exposure response with
increasing cumulative exposure) could result if full ascertainment
and recording of exposure-attributable effects depended on expo-
sure levels, if there were development of tolerance, or if personal
protective equipment (PPE) had been utilized by some employees
but not accounted for in analyses. Toluene diisocyanate (TDI) is
just one of numerous reactive entities that occur in composite poly-
merization systems in manufacturing (e.g., cyanoacrylates, ABS,
epoxy resins). The literature reveals complaint-initiated investiga-
tions of such materials which subsequently report no apparent as-
sociation of respiratory problems with duration and other exposure
measures at current exposure levels, but without accounting for
HWSE or other violations of the assumed model [e.g., Goodman
et al. [3]].
Creator
Robert M. Park
Publisher
Elsevier Korea LLC
Date
March 2022
Contributor
Sri Wahyuni
Format
PDF
Language
English
Type
Text
Coverage
Safety and Health at Work Vol. 13 Issue 1 2022
Files
Citation
Robert M. Park, “Safety and Health at Work Vol. 13 Issue 1 2022
Author’s Response to Letters to the Editor regarding “Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies” (Letter to the Editor),” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2238.
Author’s Response to Letters to the Editor regarding “Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies” (Letter to the Editor),” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2238.