[Atopic dermatitis and occupational aptitude].
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Adult↗
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Results for “OCCUPATIONAL DERMATITIS”
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Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?
Autoeczematization is characterized by the sudden dissemination of a previously localised form of eczema. While widely described, most cases reported have followed chronic, localized stasis dermatitis. In this study, we describe the clinical scenario of occupational contact dermatitis (OCD) triggering endogenous-like eczema in atopic individuals, who often have not had eczema since childhood, if at all. These cases appear similar to previously described cases of autoeczematization. To show this clinical scenario, a series of 6 patients is presented from the Occupational Dermatology Clinic in Melbourne, Australia. These workers initially developed OCD, usually affecting the hands, which then precipitated a flare of more generalized eczema. This appeared clinically consistent with atopic eczema (AE), and often became recurrent, and sometimes persistent. OCD can precipitate a flare of more generalized eczema, in a pattern consistent with AE, which may then persist. The clinical scenario is similar to that described for autoeczematization. It is possible that the pathophysiology, when clarified, will prove to be similar. Workers' compensation issues may become complicated for these patients, as the relationship between their generalized eczema and their occupational exposures may not be readily apparent. As a result, the work relatedness of their condition may not be recognized.
Adolescent↗
Is a worker's understanding of their diagnosis an important determinant of outcome in occupational contact dermatitis?
The possible effect of an individual's knowledge of their diagnosis on their disease outcome was examined in a group of 230 workers with occupational contact dermatitis. The workers were surveyed with an interviewer-administered questionnaire for an average of 5 years following a diagnosis of occupational contact dermatitis. 48% had allergic contact dermatitis and 52% had irritant contact dermatitis. There was a poor correlation between the workers' recalled diagnosis and the actual diagnosis, but better concordance with their recollection of patch test results. Only 33% correctly identified their diagnosis. Those who could not were approximately 2 x as likely to still have active dermatitis, to have more severe dermatitis and to note that their skin problem interfered with their work and home activities. Those who had no idea of their diagnosis were 3 x as likely to have these problems. These results raise the possibility that further efforts directed at the patient's education with respect to their condition might improve the outcome of their occupational skin disease.
Adult↗
Occupational contact dermatitis among the traditional 'tie and dye' cottage industry in Western Rajasthan.
BACKGROUND: Dyeing is an age-old process and forms an integral part of textile industries. Tying is a process by which a particular part of cloth is prevented from the process of dyeing. The skin diseases in workers engaged in the 'tie and dye' industry have not been extensively studied. AIMS: To study the prevalence of contact dermatitis among workers engaged in the 'tie and dye' industries in and around Jodhpur (Western Rajasthan). METHODS: One thousand three hundred workers engaged in 'tie and dye' work were evaluated for occupation-related dermatitis. Those with skin lesions were subjected to patch tests using 2% aqueous solution of the dyes and chemicals commonly used by them. These included direct dyes, VAT dyes, sulfur dyes and azo dyes. Fifty workers without skin lesions served as controls. RESULTS: One hundred patients (7.69%) had dermatitis involving the exposed sites, mainly the hands and forearms. Eighty-one patients showed positive reactions to one or more dyes, most commonly Red RC base (azo dye), followed by naphthol. CONCLUSION: Red RC base and naphthol were the commonest allergens in the 'tie and dye' industry.
Adolescent↗
Outcome of job change in patients with occupational chromate dermatitis.
Patients with allergic contact dermatitis due to dichromate are reputed to have a bad prognosis. Based on the Swiss Law on Accidents Insurance, the Swiss National Accidents Insurance Organization (SNAIO) may issue a declaration of medical inability (DMI) in cases of severe occupational dichromate dermatitis. With such a DMI, an employee is not allowed to perform any further work in contact with dichromate or cement. In this study, we reviewed medical records from 88 construction workers with DMI due to occupational dichromate dermatitis, between 1986 and 1989. Follow-up was performed by standardized questionnaire. 63 patients (72%) healed in the first few years after DMI. These patients mostly changed industry and strictly avoided all contact with cement or chromium salts. A few retired early. The outcome of our study is favorable in comparison to studies from other countries without the DMI mechanism. We conclude that strict allergen avoidance enforced by authorities, and financial support in the case of job change, are important factors in improving the prognosis in occupational dichromate dermatitis.
Adult↗
[A case of occupational contact dermatitis due to hydroxylamine].
A 36-year-old man, working in a chemical industry, had a generalized pruritic eruption. A forty-eight hour patch test revealed positivity for 1% hydroxylamine. Prevention of exposure to this chemical resulted in a dramatic improvement of the symptoms. Based on these findings, we diagnosed this case as occupational contact dermatitis due to hydroxylamine. There has been few case reports of contact dermatitis due to hydroxylamine. Histopathological examination revealed a marked spongiosis and a spongiotic bulla formation in the epidermis and follicular infundibulum, suggesting an allergic reaction.
Adult↗
Career counsellors and occupational contact dermatitis.
Career counsellors are in a unique position to provide timely preventive advice to young people at risk of developing occupational contact dermatitis. Career counsellors need to be aware of risk factors for this condition, including atopic eczema, and of high-risk occupations, such as hairdressing. A cross-sectional survey of 82 career counsellors was conducted at an Australian career counsellors' conference. 24 (29%, 95% confidence interval (95% CI) 19-40%) correctly identified eczema as a risk factor. 25 (30%, 95% CI 21-41%) indicated consideration of past skin problems during career counselling. 30 (36%, 95% CI 25-47%) correctly reported at least 1 high-risk occupation, with hairdressing being most frequently identified. Only 3 of the 82 (4%, 95% CI 0-7%) correctly answered all 3 questions.
Attitude↗
An epidemic of occupational contact dermatitis from an immersion oil for microscopy in laboratory personnel.
Since November 1997, 14 successive cases of occupational contact dermatitis were observed in 13 laboratory technicians and 1 physician, working in a genetics laboratory in Leuven (Belgium) in 3 laboratories of bacteriology in Strasbourg, Montbeliard and Angers, and in the laboratory of hematology in Bordeaux (France). The dermatitis, located on the hands, forearms and face, relapsed after each exposure to an immersion oil for microscopy. Patch tests performed in 10 patients were positive to epoxy resin (ER) in the European standard series (10/10 patients) and to newly formulated Leica immersion oil (7/7), 1 patient testing negatively with the former oil. A breakdown performed in 2 patients with the oil's ingredients confirmed sensitization to liquid modified ER components, contained at >80% concentration in the oil. The presence of DGEBA was demonstrated by HPLC analysis at a +/-30% rate. Although the safety data sheet indicated a revision of the formula, nobody was alerted to the risk of sensitization and the need for skin protection. ERs, as a source of occupational allergy, can provoke epidemics of contact dermatitis in industry. This report of epidemic contact dermatitis from ERs, used for their optical properties in an immersion oil for microscopy, emphasizes the need for perpetual vigilance in occupational medicine and the usefulness of multicentre contacts in dermato-allergology.
Adult↗
Contact dermatitis and occupational skin disease.
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Dermatitis, Occupational↗
[On allergic dermatitis and occupation].
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Dermatitis, Atopic↗
Skin cleansers for occupational use: testing the skin compatibility of different formulations.
OBJECTIVES: Skin-compatible hand cleansing is crucial for the prevention of occupational dermatitis. In this article we give an overview of skin-cleansing products and their ingredients and investigate whether solvents or abrasives could be avoided in cleansers for severely soiled skin. METHODS: Comparison of skin compatibility, cleansing power and effectiveness of different formulations of skin cleansers was performed via Duhring chamber tests [visual score, trans-epidermal water loss (TEWL)] and standard hand-wash tests. RESULTS: The results show that, dependent on the grade of contamination, a range of skin cleansers that allow adequate skin cleansing, is necessary. Solvents could be avoided, by the use of powerful cleansing systems based on tenside/oil mixtures. Only for special contaminations may solvents be useful. Powerful cleansing activity could be performed without abrasives. CONCLUSIONS: The worker must be able to choose the skin cleanser that is adequate for the contamination that is present. Therefore, information and education of the workers are crucial for skin-compatible skin cleansing.
Anti-Infective Agents, Local↗
Increase in sensitization to oil of turpentine: recent data from a multicenter study on 45,005 patients from the German-Austrian Information Network of Departments of Dermatology (IVDK).
Contact allergy to oil of turpentine was reported to have become rare. However, the evaluation of standardized data of 45,005 patients tested 1992-1997 in 30 Dermatological Centers associated with the German-Austrian Information Network of Departments of Dermatology (IVDK) showed an increase in positive patch test reactions to turpentine from 0.5% during the years 1992-1995, up to 1.7% in 1996 and 3.1% in 1997. In particular, 17,347 patients tested in 1996-1997 were evaluated in detail by comparing 431 individuals with positive patch test reactions with the rest of the group found negative to turpentine. Using the so-called MOAHLFA index, the following characteristics were shown. Turpentine allergy (a) was found to be significantly less frequent in men and in patients with occupational dermatitis, (b) showed no difference in its association with atopic dermatitis, (c) patients with turpentine allergy had significantly less symptoms of the hands, more symptoms of the legs or in the face and (d) were significantly more often aged over 60 years. Also, patients sensitized to turpentine had increased rates of additional sensitizations. The definite reason for the increase in turpentine sensitization in the population tested here is not clear. Therefore, a detailed exposure analysis is necessary; the new increase in turpentine allergies may be due to popular topical remedies or household chemicals.
Adult↗
An analysis of 501 consecutive contact clinic consultations.
A simple micro-computer program was used to analyse the results of testing 501 consecutive patients attending a patch test clinic. 64% of males and 71% of females had positive tests; 17% of males and 12% of females had occupational dermatitis; 16% of males and 15% of females had irritant contact dermatitis; and 13% of males and 19% of females had a history of atopic eczema.
Adolescent↗
A prospective study of the development of hand eczema in an automobile manufacturing industry.
We have not been able to find any prospective study of the risk of developing occupational dermatitis in the car manufacturing industry. To try to define individual predictive risk factors for the development of hand eczema and to determine the prevalence of hand eczema within 1 year in an automobile manufacturing industry, we investigated prospectively 1564 new employees during one year of employment. Only persons with previous atopic dermatitis or hand eczema were restricted to dry and clean workplaces. The employees were personally interviewed and examined before their employment. Written questionnaires were used at 3 and 12 months to obtain information on type of work, exposure, protection and hand dermatitis. All patients developing hand eczema were examined, patch tested and followed to determine the course and consequence of their eczema. The risk turned out to be only 4% on average, but significantly higher in females (6%). Certain sections within the factory such as wet work (canteen/kitchen and cleaning) and work in the paint shop with high exposure to organic solvents carried significantly higher risks. Heavy exposure to mineral oil, a known risk factor, was effectively counteracted by the extensive use of protective gloves to yield a lower than average prevalence in the press and body shop. Individual risk factors for the development of hand eczema were previous hand eczema, atopic dermatitis, but also wool intolerance and hay fever as isolated phenomena. Most cases of hand eczema were mild, of irritant contact type and only 1 employee developed an allergic contact dermatitis due to the working environment.(ABSTRACT TRUNCATED AT 250 WORDS)
Automobiles↗
Contact allergy to allyl glycidyl ether present as an impurity in 3-glycidyloxypropyltrimethoxysilane, a fixing additive in silicone and polyurethane resins.
We present a 43-year-old man who worked in the plastics industry and who suffered from an occupational dermatitis on the hands and forearms. He was found to be allergic to an epoxy silane compound that was contaminated with allyl glycidyl ether, a reactive epoxy diluent. HPLC analysis and patch testing indicated that this impurity was probably the only sensitizer. Moreover, the gloves used provided absolutely no protection, as the inner side also generated strong positive reactions.
Adult↗
Immediate skin and mucosal symptoms from pot plants and vegetables in gardeners and greenhouse workers.
Short-lived occupational skin symptoms of irritant or urticarial nature were commonly reported among 253 attendants in a clinical study on occupational dermatitis in Danish gardeners and greenhouse workers. Aimed prick or scratch-patch testing for immediate skin and mucosal symptoms was performed in 105 persons with plants as is. 35 persons (33%) had at least 1 positive reaction and a family history of, or personal, atopy was significantly more prevalent among these compared to attendants with negative reactions. Positive histamine release tests made immunologic etiology probable in Schlumbergera cacti, Stephanotis floribunda, Euphorbia pulcherrima and Gerbera reactions. Other new species implicated in immediate-type reactions included Ficus pumila, Gardenia jasminoides, Hibiscus rosa-sinensis, Campanula, Columnea, Epipremnum aureum, Pelargonium and Primula vulgaris. Because of the high prevalence of short-lived skin symptoms and because contact urticaria may present itself as a dermatitis, it is recommended that one supplement patch tests with tests for immediate reactions.
Adolescent↗
Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second series.
BACKGROUND: Although many allergens in metalworking fluids (MWF) are identified, there are still some MWF components, which are not sufficiently investigated concerning their sensitizing properties. OBJECTIVES: To investigate sensitization to 10 frequently used MWF components, which are not part of the established MWF test series, in metalworkers with suspected occupational dermatitis due to MWF. PATIENTS/METHODS: Oleyl alcohol, myristyl alcohol, dimethylolurea, 4,4'-methylenebis morpholine, imazalil, 1-amino-2-propanol (monoisopropanolamine; MIPA), 2-amino-2-ethyl-1,3-propanediol (AEPD), 2,5-bis(n-octyldithio)-1,3,4-thiadiazole, zinc alkyl dithiophosphate and dibenzyl disulfide have been patch tested in 144 patients. RESULTS: 7 patients reacted positively to the formaldehyde releaser 4,4'-methylenebis morpholine, and 6 of these patients also reacted to formaldehyde and/or other formaldehyde releasers. 4 patients reacted positively to myristyl alcohol tested at 10% petrolatum (pet.). Additionally, 20 doubtful or irritant reactions occurred. 1 patient each reacted positively to oleyl alcohol, MIPA, and AEPD. None of the other test substances mentioned above elicited any clear-cut positive reaction. Patch testing with well-known MWF allergens showed proportions of positive reactions, which were comparable to those from other studies, e.g. 11% to monoethanolamine, 8% to colophonium and 3%-5% to various preservatives. CONCLUSIONS: 4,4'-methylenebis morpholine may be an important MWF allergen, although clinical relevance could not be stated definitely in every case. Myristyl alcohol should not be patch tested at 10% pet., but at a lesser concentration, due to irritant properties.
Adult↗
Prevalence of cement eczema in Denmark before and since addition of ferrous sulfate to Danish cement.
This is a study of the prevalences of chromate allergy and hand eczema among workers engaged in the manufacture of pre-fabricated concrete building components in Denmark in 1981 and again in 1987. In September 1981 the chromate content of cement manufactured and sold in Denmark was reduced to not more than 2 ppm (parts per million) of water-soluble chromate. This was accomplished by adding ferrous sulfate, thus increasing the cost of the cement by about 1%. There was a statistically significant decrease in the prevalence of chromate allergy and hand eczema following the addition of ferrous sulfate, but there was no change in the frequency of skin irritation. The economic benefit of adding ferrous sulfate was demonstrated by a decrease in the need for dermatological services and topical steroid treatment. Cement eczema as a result of chromate allergy is a common occupational dermatitis among workers in the building and construction industries and a reduction in the chromate content of cement would appear to be a reasonable preventive measure in areas where there is a large concentration of construction industries.
Adolescent↗