Evaluation of occupational dermatitis cases (original) (raw)
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Contact Dermatitis, 2004
Irritant contact dermatitis (ICD) is often chronic; its aetiology frequently being related to occupational exposure. Management of ICD involves persistent reduction in exposure to skin irritants such as water, detergents and prolonged occlusion by gloves. The aim of this study was to determine the severity of hand dermatitis 5 years after initial diagnosis and to find out what factors were related to this outcome. A questionnaire survey was carried out on severity of hand dermatitis, exposure to skin irritants and preventive measures, 5 years after initial ICD diagnosis. Of a cohort of 201 patients with ICD, 172 received the questionnaire and 124 (72%) responded. 5 years after initial diagnosis, 50% still had medium and 32% severe hand dermatitis. Patients with severe ICD and high exposure showed low levels of prevention, and difficulty in changing their occupational exposure. Use of emollients was predominantly therapeutic rather than preventive. Occupation was changed in 57% of cases, of which 46% was permanent. In this population, ICD is a chronic disease; implementation of secondary preventive measures appears to fail. In occupations with high exposure to skin irritants, implementation of permanent exposure reduction is more difficult, compared to occupations with a medium level of exposure. High exposures might have led to change of occupation; medium exposures could have been reduced to low levels. In occupations with high exposure women were over-represented.
International Archives of Occupational and Environmental Health, 2004
Contact sensitizations in metalworkers with occupational dermatitis exposed to water-based metalworking fluids: results of the research project ''FaSt'' Abstract Background: The composition of water-based metalworking fluids (wb MWF) is complex, and various admixtures may be added before or during usage. Wb MWF may cause irritant as well as allergic contact dermatitis. While several current case reports point towards allergens particularly related to wb MWF, systematic studies have not been performed for several years. From 1999 to 2001, a study on contact allergies among patients with occupational dermatitis (OD) called ''Fru¨hzeitige Erkennung allergener Stoffe bei beruflicher und nicht-beruflicher Exposition'' (German acronym: FaSt) was conducted by the Information Network of Departments of Dermatology (IVDK), funded by the employers' liability insurances in Germany (HVBG). Objective: The objective of FaSt was to detect sensitization patterns related to particular occupational exposures. Methods: Anamnestic and clinical data were gathered using a standardised questionnaire. Patch test results were recorded by computer within the IVDK routine procedure. In addition to descriptive statistical analyses, logistic regression analysis was performed to control the effect of potential confounders. Results: Among the 1842 OD patients in the FaSt study, there were 160 metalworkers exposed to wb MWF, whose data is presented in this paper. A specific allergen pattern of these patients can be described: most frequently, sensitizations to monoethanolamine (MEA), colophony/abietic acid, and fragrance mix were observed. Additionally, cobalt, formaldehyde, formaldehyde releasers and other biocides are important allergens in these patients. Conclusions: Preventive measures and aimed in-depth research may be based on these results. The special MWF test series have to be kept up to date based on exposure information from the MWF industry and on continuos surveillance of the target group.
714 Occupational contact dermatitis
Allergy and Immunotoxicology, 2018
The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in better targeting efforts to reduce the burden of skin disease at work.
Evaluation of occupational allergic contact dermatitis and its related factors in Iran
Medical journal of the Islamic Republic of Iran, 2016
Occupational contact dermatitis, especially in hand, is one of the most common occupational disorders. The present study aimed at evaluating patients with occupational allergic contact dermatitis (ACD) caused by common allergens based on occupation type and disease history. This cross-sectional study aimed at evaluating the data of the patients with probable diagnosis of ACD in Center for Research and Training in Skin Diseases and Leprosy (CRTSDL) in Iran. In the present study, 946 patients were assessed from different regions of Iran. One hundred fifty-one cases with positive patch test and relevant exposure were entered into the study; data related to their occupation and disease activity history were evaluated and recorded. Then, factors related to disease activity history were assessed considering the occupational groups and common exposures. Nickel sulphate was the most common allergen in the 151 patients. Disease activity was constant in 29.8% of the patients; it increased in ...
Occupational Allergic Contact Dermatitis in Healthcare Workers
Revista da Sociedade Portuguesa de Dermatologia e Venereologia, 2017
RESUMO-Introdução: A dermatite de contacto alérgica (DCA) constitui patologia profissional particularmente frequente em profissionais de saúde. Os alergénios responsáveis podem variar ao longe do tempo, com a exposição ocupacional e com o tipo de trabalho. Objectivos e Métodos: Com o objetivo de avaliar a realidade local, foi feita uma análise retrospetiva dos profissionais de saúde que realizaram testes epicutâneos no Serviço de Dermatologia do Centro Hospitalar e Universitário de Coimbra (CHUC), num período de 6 anos (2010-2015), por suspeita de dermatite de contacto alérgica. Os doentes foram todos testados com uma Série Básica e com séries complementares orientadas pela história clínica. Resultados: Dos 1858 doentes testados, 125 (6,7%) eram profissionais de saúde, 114 de género feminino/11 masculino, idade média de 39,26±12,5 anos, maioritariamente enfermeiras (56), assistentes técnicos (48) e médicos (21), 71 com dermatite das mãos (56.8%), 22 com dermatite atópica e/ou outros sinais de atopia (17,6%). Noventa (72%) revelaram pelo menos um patch test (PT) positivo, 47 dos quais (52,2%) com relevância profissional. Doentes com dermatite das mãos tiveram mais frequentemente PT positivo (76,1%). Os metais causaram maior número de PT positivos (total 51; Ni-41, maioritariamente com relevância passada, Co-8; Cr-2), seguidos das fragrâncias (total 30; mistura de fragrâncias (FM)-I-10; Myroxylon pereirae-8; lyral-5; FM-II-4; citronellol-3), conservantes (total 29, dos quais 20 à metilisotiazolinona (MI) e/ou clorometilisotiazolinona/MI (MCI/MI)), borrachas (24; P-fenilenodiamina (PPD)/Isopropil-PPD-9) e medicamentos tópicos (total 14; iodopovidona 5). As principais causas da DCA profissional foram os desinfetantes/sabonetes líquidos e produtos de higiene dos doentes (15), borracha das luvas/calçado (12) e medicamentos sistémicos ou tópicos (8 antissépticos e 3 antibióticos parentéricos). Os principais alergénios com relevância profissional foram a MI e/ou MCI/MI (15), lanolina (9), formaldeído e/ou libertadores (7), iodopovidona (5), carbamatos (4), FM-I (3), cefalosporinas (3) e acrilatos (3 dentistas e/ou assistentes dentários). Em 37 dos 42 casos avaliados, houve uma melhoria franca ou resolução da DCA, após evicção do alergénio causal, nomeadamente o conservante MCI/ MI contido num sabonete líquido sob a designação de "Acticide ® MV". Conclusões: A dermatite das mãos, a principal apresentação da DCA em profissionais de saúde, não mostrou relação com atopia e foi mais frequentemente associada a PT positivos. PT positivos a isotiazolinonas e libertadores de formaldeído foram mais frequentes entre profissionais de saúde do que na população geral estudada, muito provavelmente devido à exposição cumulativa, pessoal e profissional, a estes conservantes em sabonetes líquidos de uso pessoal e hospitalar. O PT foi crucial para orientar individualmente os doentes e para alertar a comunidade hospitalar para a presença de alergénios no local de trabalho e estabelecer medidas preventivas mais adequadas.