The present investigation of workers from a newly built modern TDI-based polyurethane foam factory in Eastern Europe provides a rare opportunity to evaluate the risk of TDI asthma among workers employing state-of-the-art polyurethane foam production technology. A prospective inception cohort study was initiated with the initial group of workers (N=49) employed at the plant. Respiratory health and TDI-specific IgG and IgE were assessed pre-employment, and reassessed along with exposure potential at 6-month intervals post-employment. Data from the 12-month study period showed that almost 25% of the initial workers were not available for follow-up and 14.2% had findings that could indicate risk for the development of isocyanate asthma