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Ethics declarations Competing interests J.M.R has been a paid consultant to Aquestive Pharmaceuticals, Danone Nutricia, Mallinckrodt, Eisai Pharma and Zogenix, and has served on the Scientific Advisory Board of The Charlie Foundation for Ketogenic Therapies (Santa Monica, CA, USA)

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Reasons for differences in observed incidence are intensity of isocyanate exposure, criteria for diagnosis, mode of calculation, sensitizing capacity of different isocyanates, individual predisposition and confounding factors