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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
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1989

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↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1988

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↗
PubMed1988

Dermatitis from plastic tote boxes impregnated with an antistatic agent.

An outbreak of dermatitis occurred among employees of a microelectronics firm. In a cross-sectional epidemiologic investigation, we found that dermatitis of the hands or arms had occurred among 14 of 29 (48.3%) employees of the incoming inspection department where plastic tote boxes recently purchased from one manufacturer had been used, compared to only one case among 17 (5.9%) employees in another department which had not used these boxes. Affected workers could detect an oily film on the surfaces of these new boxes, but not on older ones. We identified the oily film to be a surface accumulation of bis-hydroxyethyl-tallow amine (BHETA), an antistatic agent with which the tote boxes had been impregnated. Subsequent toxicologic investigation established that BHETA could provoke both follicular and nonfollicular irritant dermatitis, and was also a potential skin sensitizer. Antistatic agents should be considered as potential causes of dermatitis among employees who handle electrical parts transported in plastic boxes, particularly when affected employees can detect an oily film on the box surfaces.

Amines↗
PubMed1988

Occupational vitiligo due to unsuspected presence of phenolic antioxidant byproducts in commercial bulk rubber.

We investigated the occurrence of cutaneous depigmentation (vitiligo) among employees of a company that manufactured hydraulic pumps. The interiors of these pumps were injection-molded with rubber. We identified a small but significant cluster of vitiligo cases among a group of employees who frequently handled the rubber used in this injection molding process. Although none of the additives specified in the rubber formulations was a phenolic or catecholic derivative, known to be potential causes of chemically induced vitiligo, gas chromatographic analysis identified a para-substituted phenol (2,4-di-tert-butylphenol, DTBP) in solid samples of the most frequently used rubber. Surface wipe analysis confirmed that workers could be exposed to DTBP from simple handling of the rubber. We subsequently established that the solid bulk rubber used as the base in these stock rubber formulations contained both DTBP and smaller quantities of p-tert-butylphenol. Both had formed as unsuspected byproducts during chemical synthesis of two antioxidants added to the solid bulk rubber by a major rubber supplier. We conclude that the unsuspected presence of potential chemical depigmenting agents in solid bulk rubber, from which industrial rubber products are formulated, may contribute to the occurrence of occupational vitiligo, and that a simple review of ingredients in rubber formulations is inadequate to detect their presence.

Adult↗
PubMed1988

Post-traumatic eczema.

Thirteen cases of eczema that followed acute cutaneous trauma were observed. On the basis of the present case series, the following conclusions may be drawn: 1. Cutaneous trauma may precipitate eczema. 2. The trauma is sufficient to cause obvious tissue damage accompanied by an inflammatory or regenerative response. 3. Eczema usually begins within a few weeks of acute injury at the site of the cutaneous trauma. 4. Eczema may occur as an isolated idiopathic reaction or as an isomorphic reaction either preceding or following the appearance of an endogenous eczematous condition in nontraumatized skin. 5. Individual lesions of post-traumatic eczema may persist or recur for long periods of time. 6. The occurrence of post-traumatic eczema following occupational injury has important medicolegal implications.

Adult↗
PubMed1987

Granulomatous reaction to purple tattoo pigment.

An acute dermatitis overlying an immunologic granuloma was noted at the site of purple "dye" injection in a man with multiple multicolored tattoos. The skin reaction was observed 3 weeks after the injection, which proved to contain manganese, the usual metallic salt used for purple colored tattoos. Atomic absorption spectrometry showed a large amount of manganese in the biopsy specimen. Neither the dermatitis nor an immunologic granuloma could be reproduced with manganese salts or the alleged tattoo pigment. In addition, his peripheral blood lymphocytes were shown to be normal both in subset distribution and in their function, but these cells did not respond by blastogenesis to dilutions of the alleged pigment or to 2 manganese salts tested.

Adult↗
PubMed1987

Knuckle pads in live-chicken hangers.

A study of live-chicken hangers in a poultry processing plant demonstrated a high prevalence of callosities over the knuckles (knuckle pads) of both hands. Knuckle pads were observed in 56% (23/41) of live-chicken hangers, but in no (0/41) workers from other departments (p less than 0.001). The probable cause was the repeated striking and sliding of the knuckles against metal shackles in which live birds were being placed. Additional medical and ergonomic evaluation would be worthwhile to confirm the probable cause, to determine whether associated tissue disorders are present in the digits of chicken hangers who develop knuckle pads, and to suggest preventive measures.

Adult↗
PubMed1987

Surveillance of work-related cold injuries using workers' compensation claims.

The usefulness of workers' compensation claims for the surveillance of occupational injuries was evaluated by analyzing claims for cold injury. Five hundred ten claims filed in 1983 from 23 states participating in the Bureau of Labor Statistics Supplementary Data System and an additional 147 claims filed with the Division of Safety and Hygiene of the Industrial Commission of Ohio from Jan 1, 1984, to June 30, 1985, were examined. As expected, the number of injuries per winter day increased as temperature decreased and wind speed increased. The rate of injury began to increase when temperatures fell below 10 degrees F and wind speeds exceeded 10 mph. These weather conditions were milder than previously published cold hazard charts suggest. Frostbite injuries of the lower extremities occurred at milder temperatures, required more lost workdays, and were more costly than cold injuries to the head and face or to the upper extremities. Industries with the highest rates of injury included agriculture, oil and gas extraction, trucking and warehousing, protective services, and interurban transportation. Injuries during nonwinter months involved the processing, distribution, and preparation of food. Vehicle breakdown or contact with water, gasoline, alcohol, or cold water were noted as contributing factors on many of the compensation claims. This probe suggests that claims for workers' compensation adequately reflect the expected association of environmental factors and the occurrence of cold injury.

Absenteeism↗
PubMed1987

Phytophotodermatitis from celery among grocery store workers.

We detected 19 cases of phytophotodermatitis during a cross-sectional epidemiological investigation of two Oregon grocery stores that were part of the same supermarket chain. Outdoor sunlight exposure during the workshift and tanning salon use were identified as risk factors; the most severe cutaneous reactions tended to occur among tanning salon users. Although both stores carried the same brands and varieties of produce, all 19 cases occurred among employees of one store, which had held a celery sale coincident with the outbreak, resulting in a quadrupling of the usual volume of celery sold. We found elevated psoralen levels in two of three celery samples obtained from the affected store; cutaneous provocation tests with trimmed surfaces of these celery samples produced phototoxic reactions. Preliminary experiments with one brand of celery have demonstrated psoralen levels as high as 25 micrograms/cm2 of trimmed surface. These observations suggest that clinical phytophotodermatitis among grocery store workers may be caused by healthy celery and results from a complex interaction of exposure variables, including ultraviolet radiation from tanning salon use, frequency of handling celery, celery brand, and sporadic elevation of psoralen content from environmental stresses.

Cross-Sectional Studies↗
PubMed1987

Allergic contact dermatitis from a nonbisphenol A epoxy in a graphite fiber reinforced epoxy laminate.

An employee of the Composites Division of an aircraft engine manufacturing firm developed dermatitis associated with the handling of a graphite fiber reinforced epoxy laminate (epoxy prepreg). Patch test investigation demonstrated that the responsible causal agent was the nonbisphenol A epoxy binder, 4-glycidyloxy-N, N-diglycidylaniline. A patch test with bisphenol A epoxy from a standard patch test screening series was negative. Subsequent interviews with employees of the Composites Division suggested that a relative lack of awareness of the cutaneous hazards of fiber reinforced epoxy laminates, compared with liquid epoxy resin systems, may be an important risk factor for allergic sensitization to these composite materials.

Adult↗