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Persistent post-occupational dermatitis.

Wall and Gebauer (Contact Dermatitis 1991: 24: 241-243) first described persistent post-occupational dermatitis (PPOD) as ongoing dermatitis for which there is no obvious present cause, precipitated by prior occupational contact dermatitis (OCD). We propose that individuals exhibiting PPOD lose the capacity for resolution of their condition upon removal from exposure to causative agents and subsequently develop persistent dermatitis, which can be continual or intermittent. Accordingly, we suggest modification of criterion 6 of the OCD criteria developed by Mathias (J Am Acad Dermatol 1989: 20: 842-848): 'Removal from exposure initially leads to improvement of dermatitis, however, over time there may be incomplete or no improvement, despite removal from exposures at work'. To satisfy the definition of PPOD, individuals must meet at least 4 of the 7 criteria, including the altered criterion 6. We present 6 cases of PPOD exemplifying these scenarios, which met the altered Mathias criteria. In some cases, subsequent failure to recognize the initial work relatedness of their skin conditions resulted in the termination of workers' compensation benefits. This situation is particularly relevant in the Australian context. The diagnosis of PPOD needs to be considered in all individuals with work-initiated dermatitis who present with ongoing endogenous-like eczema.

Adult↗
PubMed1981

Occupational dermatitis. An epidemiological study in the rubber and cement industries.

An epidemiological study of occupational dermatitis in a tyre company and a cement company is reported. Ninety-seven percent of 999 tyre workers and 78% of 151 cement workers were screened by an occupational nurse and subsequently assessed by a specialist dermatologist. Prevalence rates of occupational contact dermatitis were 37 per 1000 and 68 per 1000 in the tyre and cement companies, respectively. Maintenance workers and tyre builders - particularly if they were Yugoslav and female - had high prevalence rates amongst tyre workers. Worker's compensation claim rates for the tyre company are similar to U.K. and U.S. rates for this industry. Prevalence rates of 37 per 1000 can be considered as a lower limit for this industry. The high prevalence rates in the cement company are noteworthy and require further study.

Australia↗
PubMed1979

Occupational dermatitis artefacta.

Nine cases of disease malingering with skin lesions attributed by the patients to occupational factors are reported. History and morphology of the lesions provided sufficient grounds for the diagnosis of occupational dermatitis arterfacta. Four out of nine patients admitted to having produced these artefacts.

Adult↗
PubMed1998

Occupational dermatitis in Danish gardeners and greenhouse workers (II). Etiological factors.

The aim of the study was to assess the distribution of different types of occupational eczema among employees in floristry and detect the allergens most commonly involved. Based on a postal questionnaire, 253 gardeners and greenhouse workers with occupational skin symptoms and 52 randomly-selected without symptoms were examined and patch tested. Routine tests comprised the standard series, the Compositae mix, feverfew and 3 fungicides, with additional testing based on case records. 184 persons from the symptom group and 1 from the random group had occupational eczema. Irritant occupational contact eczema was suspected in 150 persons (59%). Nevertheless, 48% of the 250 persons patch tested had at least 1 positive reaction, most frequently to nickel, followed by Compositae which were positive in 25 cases (10%), of whom 24 were possibly occupationally sensitized. 13 persons from symptom group had positive reactions to fungicides. Occupational allergic eczema was suspected in 43 persons (17%), most often caused by plants belonging to the Compositae, Geraniaceae and Liliaceae families. New plant sensitizers were Exacum affine and Begonia lorraine. Exposure to specific plant species seemed to be the most important eliciting factors in both allergic and irritant occupational dermatitis in floristry, and preventive measures should include reduction of contact with plants.

Adult↗
PubMed1992

Essentials of occupational contact dermatitis.

Occupational skin disease constitutes a disproportionately large percentage of all occupational illnesses. It is beneficial for the nurse to have a clear understanding of the relationship between the worker and occupational contact dermatitis. This article describes background information, diagnostic testing, and preventive measures.

Adrenal Cortex Hormones↗
PubMed1997

Occupational dermatitis transferred with job duties.

Astroemeria is an increasingly common cause of allergic contact dermatitis. We report a case of occupational contact dermatitis that was transferred with job duties. When advising patients about their risk, it is advisable to discuss the risk to others in the setting as well.

Allergens↗
PubMed2002

[Prevention of occupational dermatitis].

The prevention of the occupational skin disease is essential to avoid some clinical complications and to preserve job. The suppression of the responsible factor is rarely possible at work, but when it is possible, it is efficient. The practice of real orders of prevention is the best way to proceed, writing individual and collective prevention prescriptions, which have to be very precise and adapted to every case during one sufficient time to get a good adherence of the patients. The implementation of the prevention consists of a set of advices on the prevention measures carrying on the environment, the processes or the work tools, the bad habits, and advices about the professional gestures to avoid and about the convenient information on the manner to use the means of individual prevention (gloves, protective creams and moisturizers) recommended and adapted to each work sequence.

Dermatitis, Occupational↗
PubMed1999

The epidemiology of occupational contact dermatitis.

Occupational contact dermatitis (OCD) ranks first of all occupational diseases in many countries. The incidence rate is believed to be around 0.5-1.9 cases per 1000 full-time workers per year. Epidemiological studies play an important role in observing disease trends, analysing risk factors, and monitoring the effect of preventive measures. In this review article the lack of truly epidemiologic data on OCD and the difficulties of those studies are illustrated. The following issues are highlighted: case ascertainment and bias, the distribution of allergic and irritant contact dermatitis in the working population, the interrelationship between exogenous (allergens, irritants) and endogenous factors, the prognosis, the social and economic impact, and the need for intervention studies.

Bias↗
PubMed1997

Occupational dermatitis in Danish gardeners and greenhouse workers (I). Prevalence and possible risk factors.

Floristry is considered a hazardous occupation from a dermatological point of view, but there are relatively few epidemiological studies to support this notion. The present investigation set out to assess the prevalence of and association between occupational dermatitis and possible risk factors in Danish gardeners and greenhouse workers. A cross-sectional study, based on a postal questionnaire and subsequent examination and patch testing of those who had occupational eczema from their present work or occupational problems with Compositae, was carried out in 1958 gardeners and greenhouse workers. The response rate was 84.6% and among 301 persons invited for further examination, 253 (84.1%) attended. The lifetime prevalence of occupational eczema in floristry, defined as dermatitis lasting more than 24 h, was 19.6% (95% confidence intervals 17.8-21.3%) among all potential respondents. Occupational mucosal symptoms, working with Compositae plants and a history of previous occupational eczema in floristry were significantly associated with an increased risk of occupational eczema. Sex, age and atopy did not seem to be important risk factors. The results confirm that floristry is a dermatologically hazardous occupation and emphasize the importance of eliciting agents in the working environment rather than personal inherent factors.

Adult↗
PubMed2002

[Occupational dermatitis in health care personnel].

Occupational dermatosis are frequent among healthcare workers. Irritant hand dermatitis is more common than allergic contact dermatitis. It is enhanced by the exposure to irritants: water, detergents, disinfectants and a history of atopic dermatitis. Natural rubber latex contained in rubber gloves can induce contact urticaria or generalized immediate allergic reactions. Contact eczema can be induced by rubber accelerators such as thiurams, disinfectants (glutaraldehyde, dodecyldimethylammonium). Nurses can become sensitized to handled drugs (antibiotics, propacetamol...). These occupational allergies have to be diagnosed, because sensitized nurses can develop severe generalized cutaneous adverse drug reactions if they are systemically exposed to the same drug than those that has previously induced an occupational contact allergy.

Dermatitis, Occupational↗
PubMed1985

Occupational dermatitis in shrimp peelers.

A total of 110 female shrimp production workers from 2 factories were invited to participate in an investigation of occupational skin problems. A questionnaire was filled in by 94 workers and 24 (20.2%) claimed skin problems due to working conditions. In 7 (6%), a diagnosis of occupational dermatitis of the hands was made. In 2, there were strongly positive reactions to shrimp. 5 had negative tests but a positive history of occupational provocation.

Decapoda↗
PubMed1983

[Delayed diagnosis of occupational dermatitis].

Of 182 subjects affected by occupational eczema only in 15% the eczema was found to be developed in the first three months. In 21.8% the diagnosis of occupational eczema was delayed by over 5 years. The methodological and social outcome of the delayed diagnosis was analysed.

Adult↗
PubMed1977

[Occupational dermatitis due to inhalation and ingestion].

Occupational materials contacted systemically, either by inhalation or ingestion, are capable of producing toxic as well as allergic skin reactions in exposed persons. Depigmentations of vitiligo type due to paratertiary butyl-phenol, various exanthems due to trichlorethylene fumes in the metal industry and due to alpha-phenylindole in the plastics industry, and the so-called vinyl chloride sickness in the PVC industry are examples of conditions with a probable toxic pathogenesis. Allergic skin conditions may occur as either immediate type (urticaria and Quincke's edema) or delayed type (endogenic contact eczema, more rarely pigmented purpuric eruptions) reactions. Relevant examples from the literature and our own case histories are briefly presented. Some types of eczema and dysidrosiform eruptions, which show an immediate type sensitization to occupational allergens of a protein nature in the skin tests, are difficult to interpret pathogenically. The prototype of such reactions is bakers' eczema with cutaneous vascular sensitization to flour. In addition, farmers' eczema can be related to an immediate type sensitivity to animal hair, resp. farm dust. Our own observations concerning such cases are briefly described.

Adult↗
PubMed1992

Occupational dermatitis from exposure to polyurethane chemicals.

In addition to asthma, contact dermatitis may also develop from occupational contact with polyurethane (PU) chemicals. 6 cases of allergic contact dermatitis from exposure to PU chemicals were diagnosed in 1974-1990. The present paper summarizes the results and gives detailed descriptions of 3 such patients. 3 patients were allergic to 5 different diisocyanates (DICs), including 4,4'-diphenylmethane DIC (MDI), toluene DIC (TDI), 1,6-hexamethylene DIC (HID), and furthermore to diaminodiphenylmethane (MDA). 3 patients were sensitized by exposure to MDI. 2 of these reacted to MDI and MDA, and 1 to TDI in addition. 1 of the 3 patients reacted only to MDA, possibly formed by hydrolysis of MDI. Primary sensitization to MDA and cross-allergy to MDI could explain the reactions of the patients exposed to MDI, but separate sensitization may also be possible. Patch tests with fresh petrolatum (pet.) mixtures were first made and a 2% concentration was recommended for MDI and TDI. In order to determine the stability of DIC test substances, the last 2 patients were tested with old test substances. Tests with MDI 1.5% pet. and TDI 1.5% pet., 5.5 months and 15.5 months old, were positive. The results suggest that, when allergy to PU chemicals is suspected, patch tests should include, in addition to MDA, at least MDI and TDI 1.5-2% pet. They also suggest that test substances can be used for over a year, and that allergy to MDA may point to MDI exposure contained in PU chemicals.

Adult↗
PubMed1982

[Allergens and harmful factors in the light of occupational dermatitis registration in Poland in 1978].

786 occupational dermatoses notification in Poland have been analysed. The significance of the compounds of chromium, cobalt, oils, lubricants, cement, epidians and epoxy resins in the pathogenesis of occupational dermatoses has been presented. The recommended "set of 5 allergens" is sufficient to explain the cause of about half of the diseases. Epidemiological data on occupational dermatoses confirm the advisability of adopting the author's criteria of handling occupational dermatoses and considering the possibilities of certain technological improvements.

Allergens↗
PubMed2004

Contact sensitizations in metalworkers with occupational dermatitis exposed to water-based metalworking fluids: results of the research project "FaSt".

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 "Fruhzeitige 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 continuous surveillance of the target group.

Adult↗