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Biomedical subjects

C G Mathias

Publications and source records attributed to C G Mathias.

At least 19 recordsLinked to original sources

A preliminary report of the occupation of patients evaluated in patch test clinics.

BACKGROUND: The interplay between the occupational environment and worker's skin can result in contact dermatitis of both irritant and allergic types. Other forms of dermatitis can also be influenced by occupational exposures. OBJECTIVE: The aim of this study is to compare the occupations and allergens of occupational contact dermatitis cases with nonoccupational contact dermatitis cases. METHODS: Diagnostic patch testing with allergens of the North American Contact Dermatitis Group and occupational coding by the National Institute for Occupational Safety and Health methods. RESULTS: Of 2,889 patients referred for evaluation of contact dermatitis, 839 patients (29%) were found to have occupational contact dermatitis. Of the 839 cases deemed occupational, 455 cases (54%) were primarily allergic in nature and 270 cases (32%) were primarily irritant in nature. The remaining 14% were diagnoses other than contact dermatitis, aggravated by work. The occupation most commonly found to have allergic contact dermatitis was nursing. Allergens strongly associated with occupational exposure were thiuram, carbamates, epoxy, and ethylenediamine. CONCLUSION: Some contact allergens are more commonly associated with occupational contact dermatitis. Nursing and nursing support are occupations most likely to be overrepresented in contact dermatitis clinics.

Allergens↗

Patch testing discordance alert: false-negative findings with rubber additives and fragrances.

From July 1996 through June 1998, the North American Contact Dermatitis Group evaluated 318 patients for suspected contact dermatitis by patch testing simultaneously with Finn Chambers and the T.R.U.E. Test allergen system. Discrepancies between the two systems were found in some of the results, particularly with fragrance and rubber allergens. These results suggest that positive reactions to fragrance, thiuram, and carba mix allergens may be missed if the T.R.U.E. Test is used alone.

Allergens↗

Gold allergy in North America.

OBJECTIVE: To determine the prevalence of allergic reactions to gold among patients tested by the North American Contact Dermatitis Group (NACDG) from 1996 to 1998. METHODS: This is a prospective analysis of patch test results from the 12 centers that comprise the NACDG. Gold was tested as gold sodium thiosulfate (0.5% in petrolatum [pet]), along with 49 other screening allergens, in patients presenting with possible contact dermatitis. RESULTS: Of 4,101 patients tested, 388 (9.5%) had a positive patch test result to gold. Women accounted for 62.8% of the subjects tested and 90.2% of patients positive to gold (P < .0001). The most common sites of dermatitis in gold-allergic patients were the hands (29.6%), face (19.3%), and eyelids (7.5%). Nickel and cobalt allergies, respectively, also were present in 33.5% and 18.3% of gold allergic individuals, as compared with 14.2% and 9.0% of the total population. Gold was the only positive reaction in 15.2% of the 388 patients. CONCLUSION: Gold is a more common allergen than previously reported and might cause facial and eyelid dermatitis. Hypersensitivity to gold is statistically linked to female gender and to allergic reactions to nickel and cobalt.

Allergens↗

North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens.

BACKGROUND: Allergic contact dermatitis is a significant cause of cutaneous disease affecting many individuals. Patch testing, when used properly, often provides support for the diagnosis of allergic contact dermatitis. OBJECTIVE: This article reports patch testing results from July 1, 1994, to June 30, 1996, by the North American Contact Dermatitis Group (NACDG). METHODS: Patients evaluated in our patch test clinics were tested with the same screening series of allergens by the use of a standardized patch testing technique. The data from these patients were recorded on a standard computer entry form and analyzed. RESULTS: Forty-nine allergens were tested on 3120 patients. Budesonide was added to the series in July 1995 and tested on 1678 patients. Of these patients, 66.5% had positive allergic patch test reactions, and 57% had at least one allergic reaction that was felt to be clinically relevant to the present or past dermatitis. The 20 screening allergens commercially available to United States dermatologists in the Allergen Patch Test Kit, accounted for only 54.1% of the patients with positive allergic reactions. The additional 30 allergens on the NACDG screening series accounted for 47% of patients with positive allergic reactions. Had the Allergen Patch Test Kit alone been used, 12.4% of all patients tested may have had their disease misclassified as a nonallergic disorder, and an additional 34.4% of all tested patients would not have had their allergies fully defined. Among those patients with positive responses to the supplemental allergens, 81% of the responses were of present or past relevance. The 12 most frequent contact allergens were nickel sulfate, fragrance mix, thimerosal, quaternium-15, neomycin sulfate, formaldehyde, bacitracin, thiuram mix, balsam of Peru, cobalt chloride, para-phenylenediamine, and carba mix. The present relevance varied with the specific allergen from 10.7% (thimerosal) to 85.7% (quaternium-15). Among newer allergens, methyldibromoglutaronitrile/phenoxyethanol (cosmetic preservative) caused positive allergic reactions in 2% of the patients; tixocortol-21-pivalate and budesonide (corticosteroids), in 2.0% and 1.1% of the patients, respectively; and ethylene urea/melamine formaldehyde mix (textile resin), in 5% of the patients. CONCLUSION: The usefulness of patch testing is enhanced with the number of allergens tested, because allergens not found on the commercially available screening series in the United States frequently give relevant allergic reactions.

Allergens↗

Allergic contact dermatitis from a lawn care fungicide containing dyrene.

Lawn care chemicals are frequently blamed when skin rashes occur in lawn care workers, although proof of a cause-and-effect relationship is often lacking. A lawn care worker developed severe dermatitis of the hands, arms, face, and neck shortly after his company started using a new fungicide. Patch-testing proved that the dermatitis was caused by a contact allergy to Dyrene, the active fungicidal chemical.

Adult↗

The prevalence of back pain, hand discomfort, and dermatitis in the US working population.

OBJECTIVES: The purpose of the study was to provide the health care and public health communities with national prevalence estimates of selected conditions in the US working population. METHODS: National prevalence estimates of self-reported conditions among working people were calculated from data collected for the 1988 Occupational Health Supplement to the National Health Interview Survey. RESULTS: The highest prevalence estimates were found among occupational groups. For example, the prevalence of back pain due to an injury at work among truck drivers was 6.7%; back pain due to repeated activities at work among mechanics and repairers of heavy equipment and machinery was 10.5%; hand discomfort among operators of machines that process metal, plastic, stone, and glass was 23.5%; and dermatitis due to contact with substances at work among physicians, dentists, nurses, pharmacists, and dietitians was 5.6%. CONCLUSIONS: A substantial proportion of these conditions among occupational groups with the highest prevalence estimates are occupational in origin. These prevalence estimates identify occupations in which efforts are needed to prevent these conditions.

Adult↗

Dermatitis in workers exposed to antimony in a melting process.

An employee at a brazing rod manufacturing plant developed a generalized eruption of follicular papules and pustules. His job tasks included breaking up antimony ingots and melting the pieces in a crucible; he was exposed to antimony metal dust and to antimony trioxide fumes. Two fellow employees who later performed the same job tasks developed similar eruptions. The clinical and workplace evaluations suggested that the fumes from melting antimony were the cause of the dermatoses, and that the current Occupational Safety and Health Administration permissible exposure limit is not adequate to prevent cutaneous effects of antimony exposure.

Adult↗

Surveillance of occupational skin diseases: a method utilizing workers' compensation claims.

In order to determine the feasibility of using workers' compensation claims (WCC) for surveillance of occupational skin diseases, we reviewed all WCC received in the state of Ohio from 1980 through 1984. A total of 4,214 WCC for occupational skin diseases were filed by 2,610 Ohio companies, of which 1,656 (63%) companies were classified in Standard Industrial Classification (SIC) categories with average annual WCC rates above the overall state average for skin diseases. During the five year study period, 102 companies filed six or more WCC, of which 85 (83.3%) companies were classified in SICs with above-average WCC rates. WCC from 65 (63.7%) of these 102 companies implicated either the same occupation or causal agent in 50% or more of WCC received from each respective company. Using SIC classifications with WCC rates above the state average and six or more filed WCC as measures of risk, there was good correlation between company risk ranking by SIC categorization and number of WCC filed. This study suggests that active intervention strategies to prevent occupational skin diseases can be based on primary identification of companies filing WCC, followed by secondary identification of high-risk occupations or causal agent exposures within these companies.

Environmental Monitoring↗

Chloracne associated with employment in the production of pentachlorophenol.

To evaluate the association between exposure to pentachlorophenol (PCP) and the occurrence of chloracne, we studied the medical and personnel records for individuals employed in the manufacturing of PCP. Forty-seven cases of chloracne were identified among 648 workers (7.0%) assigned to PCP production at a single plant between 1953 and 1978. The annual incidence rate varied considerably, ranging from 0 (in 1953) to 1.46 (in 1978). No linear trend in the risk of chloracne was observed with the duration of employment in the pentachlorophenol department. Workers with a documented episode of direct skin contact with PCP had a significantly increased risk of chloracne compared with workers who did not have a documented episode of direct skin contact (cumulative incidence ratio = 4.6; 95% confidence interval 2.6-8.1). Our results confirm that chloracne is associated with exposure to PCP contaminated with hexachlorinated, heptachlorinated, and octachlorinated dibenzo-p-dioxins and dibenzofurans.

Acne Vulgaris↗

Prevention of occupational contact dermatitis.

Contact dermatitis is the most frequent type of occupational skin disease. Although prevention of contact dermatitis in the workplace should ideally be accomplished through total elimination of cutaneous exposure to hazardous substances, this is often not feasible. Therefore eight basic elements of a multidimensional approach to prevention have been identified. These elements include recognition of potential cutaneous irritants and allergens, engineering controls or chemical substitution to prevent skin exposure, personal protection with appropriate clothing or barrier creams, personal and environmental hygiene, regulation of potential allergens and irritants within the workplace, educational efforts to promote awareness of potential allergens and irritants, motivational techniques to promote safe work conditions and practices, and preemployment and periodic health screening. A comprehensive prevention program based on this multidimensional approach requires the cooperative efforts of employees, employers, engineers, chemists, industrial hygienists, safety and supervisory personnel, union representatives, governmental agencies, and occupational health practitioners.

Dermatitis, Contact↗

Contact dermatitis and workers' compensation: criteria for establishing occupational causation and aggravation.

Contact dermatitis is the most common form of occupationally acquired skin disease. Eligibility for coverage under the workers' compensation laws of all states requires only reasonable probability that dermatitis directly resulted from, or was aggravated by, employment. The responsibility for this determination ultimately resides with the examining physician, who must critically evaluate the medical history and cutaneous findings. This article proposes seven objective criteria that may be used to assess the probability of a causal relationship with employment.

Dermatitis, Contact↗

Occupational skin diseases, United States. Results from the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, 1973 through 1984.

The overall incidence rates, numbers, and proportions of occupational skin diseases recorded in the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, from 1973 through 1984, were reviewed, and a detailed analysis of occupational skin diseases recorded in the 1984 Annual Survey was performed. Overall incidence rates and numbers of cases declined from 1973 through 1983, but increased slightly in 1984. The major industrial divisions of agriculture and manufacturing have consistently had the highest rates and numbers of cases, respectively; skin diseases have accounted for almost two thirds of all occupational illnesses within agriculture. In the 1984 Annual Survey, 11 industries were ranked in the "Top 15" for both incidence rates and numbers of cases, at the two-digit Standard Industrial Classification level. At the four-digit level for manufacturing, four industries were also ranked in the "Top 15" for both indexes. This analysis has identified industries toward which research efforts should be directed to characterize those occupational activities or exposures most responsible for these higher risks.

Absenteeism↗

Surveillance of occupational skin disease using the Supplementary Data System.

The utility of the Supplementary Data System (SDS) compiled by the Bureau of Labor Statistics (BLS) in conducting surveillance of occupational skin disease was evaluated by examining 14,703 workers' compensation cases reported to the SDS for the year 1981. Combined with state employment denominators obtained from the BLS Employment and Earnings Program, rates of illness (cases of dermatitis/10,000 employed) calculated for eight major industrial divisions varied significantly according to the criteria used for reporting cases. Despite quantitative variations in the rate of skin disease that depended on specific reporting criteria, the relative ranking of the major industrial divisions remained unchanged, with highest rates of skin disease consistently found in three major industry divisions: agriculture, manufacturing, and construction. This ranking of major industry divisions by rate of dermatitis corresponded extremely well with rankings generated from the 1981 Annual Survey (Spearman rank correlation = .98, p less than .01). At the two-digit level of the Standard Industrial Classification, the rankings based on the SDS had a 77% rank correlation with those from the Annual Survey. Two-digit SIC codes identified from the top 10 in both sets of rankings included crop and livestock production from the agricultural division and leather products, food products, rubber and plastic products from the manufacturing division.

Dermatitis, Occupational↗

Distribution of lost-work-time claims for skin disease in California agriculture: 1978-1983.

In order to identify California agricultural workers at high risk for occupational skin disease, we evaluated the distribution of 2,722 claims for lost-work-time skin conditions reported between 1978 and 1983 by Standard Industrial Classification (SIC) and source of illness. In the overall work force, cases were most frequently attributed to plants (52.1%), chemical exposures (20.4%), and food products (12.5%), but considerable variation occurred in the distribution of cases among the subdivisions of agriculture. The forestry subdivisions (SICs 081, 082, 084, and 085) had the highest rate (given as cases/10,000 employed) of claims for skin disease attributed to plants (53.5), but no cases due to other exposures. For chemical exposures, the highest rate of claims occurred in the horticultural specialities (SIC 018) subdivision (5.1), but this group also had a significant claims rate for plant-related skin disease (15.9). The highest claims rate for cases attributed to food products occurred in the vegetables/melons subdivision (4.7), but this group had claims rates for exposure to plants (3.8) and chemicals (2.8) that were nearly as high. Efforts to evaluate and prevent skin disease in agricultural workers should recognize the complex range of exposures to which this work force is subject.

Agricultural Workers' Diseases↗