Total cases of fatal asthma in the occupational setting reported in th
e literature are reviewed and the case of a 39-year-old foundry worker
who died at work is described. A diagnosis of occupational asthma ind
uced by diphenylmethane diisocyanate (MDI) had been assessed 5 years i
n advance through a 0.005ppm exposure inhalation challenge. Postmortem
microscopic examination of the lung showed epithelial desquamation, e
osinophilic/neutrophilic infiltration of the mucosa, dilatation of bro
nchial vessels, edema, hypertrophy and disarray of smooth muscle, Fata
l asthma attack in a MDI-sensitized individual, to our knowledge, has
not been previously described.