[Pathogenesis, clinical aspects, therapy, and prevention of occupational dermatitis].
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During the years 1988-1992 there were diagnosed 299 cases of allergic occupational eczema (115 females and 184 males). Among them 20.4% of patients were employed in health care and social welfare, 20.1% in the metallurgical and machine industries, 19.7% in the building industry and 9% in the textile and clothing industries. Allergy to nickel (45.2%), cobalt (40%), chromium (33.9%) and formalin (15.7%) was the most common cause of occupational allergy in females, while 63% of males were hypersensitive to chromium, 42.4% to cobalt, 17.4% to nickel and 14.7% to epidianes. When compared with the years 1972-1987 an increased incidence of occupational skin diseases was found especially in females, but also in health service workers as well as in workers employed by the metallurgical and machine industries. Chromium compounds still remain the main cause of occupational eczema, however, the number of persons sensitive to this metal has decreased. An increased allergy to nickel and formaldehyde and decreased allergy to turpentine have been also observed.
In an epidemiological study of occupational dermatitis in 5 different shoe factories, 246 workers were interviewed, examined and patch tested using standard and occupational patch test series. The prevalence of occupational contact dermatitis was 14.6% (36/246): 8.1% (20/246) irritant contact dermatitis (OICD) and 6.5% (16/246) allergic contact dermatitis (OACD). Among the latter, the most common occupational allergens were p-tert-butylphenol-formaldehyde resin and mercaptobenzothiazole. 6% (15/246) presented with hyperkeratosis of the fingertips, while 3.2% (8/246) reported pruritus sine materia (PSM) present only during working hours. 2 workers presented with vitiligo-like leukodermic patches on the backs of their hands and on their forearms. Some jobs were more frequently associated with skin complaints. In the assembly department, OACD was most frequent (11.4%), attributed to contact with adhesives and, to a lesser degree, with rubber and leather. OICD caused by contact with the solvents contained in adhesives and varnishes was most frequent in the assembly and trimming departments (17.1% and 15.6%, respectively). PSM, probably caused by the dust present in the working environment was reported by 33.3% of the workers in the sole-cutting and scraping departments. Hyperkeratosis of the fingertips, as a reaction to the continuous trauma of leather on the skin, was observed most frequently (41.6%) in the sole-cutting department.
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