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PubMed1975

Skin irritancy and sensitivity to laundry detergents containing proteolytic enzymes. Part II.

The late type contact sensitizing effect of alkaline protease enzymes (PE) on the intact human skin has been investigated in the present study. The immune process of sensitisation was induced with "Tenzym prilled" (TP, Grindstedvoerket) and with "Maxatase" (M, Gist-Brocades) protease enzymes in the epicutaneous test (ET), using concentration series and various durations of application. The ETs were made on the intact (symptom-free) skin, as well as under conditions promoting the subcorneal penetration of PE. Challenge was carried out at 21 to 30 days following induction of 2092 subjects, and at 2 to 5 months on 1624 subjects. Despite the large number of subjects tested, contact sensitisation developed in none of the cases, although the inducing exposure took place under conditions promoting the immune process of sensitisation. In 60 individuals suffereing from occupational dermatitis on regular contact with PE and having no symptoms of early type inhalative allergy (mucous membrane changes, bronchial asthma-like symptoms) were challenged also by the intradermal test. No reaction was noted in any of them at 10 and 30 minutes, as well as at 24 and 48 hours following the test. Next the influence of PE is analysed in the induction or increased severity of the irritation caused by bioactive laundry detergents. The studies involved the use of serial dilutions of "Biopon" (Bn) laundry detergent containing TP or M, or not containing PE, respectively, by means of the ET. A total of 740 series (5220 tests) of the three variants were applied in dilution series to intact skin surface, as well as to pathologically and arteficially lsioned skin areas. The Bn variants containing and not containing PE increased the number of irratative reactions in essentially the same degree. This suggests that the irritative effect is not due to the presence of PE, but to the laundry-active detergents (WAS) of Bn in the first place, and to a lesser extent to its other ingredients.

Chemical Industry↗
PubMed1990

Contact sensitivity to systemically administered drugs.

Allergic occupational dermatitis to drugs usually administered systemically is found most often in nurses. Affected less frequently are physicians, veterinarians, dentists, hospital cleaning people, and pharmaceutical manufacturing workers. The drug most often involved in the author's experience is penicillin.

Dermatitis, Contact↗
PubMed1989

[Cytochemical and immunological indices of patients with occupational dermatoses of chemical etiology].

A total of 161 male patients, aged 18 to 56, suffering from occupational dermatitis (n = 81) and eczemas (n = 80), have been examined with the use of cytochemical and immunological methods in an outpatient rehabilitation centre in the town of Mingechaur, the Azerbaijan SSR. The patients have been engaged in the manufacture of fiber glass, insulation material, and rubber articles; the dermatoses they have developed have been due to exposure to allergic and irritating components of nonconsolidated synthetic polymers and chemical ingredients of industrial rubber production. The findings evidence a significant increase of the neutrophil metabolic and functional activities in dermatitis patients and a rise of the lymphocyte activities in eczema patients. A complex of methods for the studies of leukocyte function and of changes in the immunity status, both on the cellular and subcellular levels (sensitization, inflammation, toxicity) is recommended for examinations of such patient populations.

Adolescent↗
PubMed1982

The possible chelating effect of sodium diethyldithiocarbamate (DDC) in nickel allergic patients. Patch test procedures with nickel on DDC pretreated skin.

Encouraged by some reports about the chelating effect of p.o. given sodium diethyldithiocarbamate (DDC) in nickel allergic patients, some experiments were performed to determinate the blocking effect of locally applied DDC on positive patch test reactions with nickel. Two groups of nickel allergic patients were patch tested with different concentrations of nickel sulphate on with DDC treated skin. Control patch tests were done on areas which were pretreated with the creambase only. In one group 10% DDC in the cream was applied under 24 h occlusion; in this group also a nickel coin was tested. In the second group of patients the DDC cream was rubbed four times during 24 h without occlusion. In both groups there were no statistical differences regarding the reactions on skin pretreated with DDC and with the cream base. From this investigation it may be concluded that there is no indication that a DDC-containing barriercream will be of great help in patients with occupational dermatitis, which is especially due to nickel sensitization.

Administration, Topical↗
PubMed1995

[Preliminary assessment of the effect of disinfectants on skin changes in health service workers].

During a five-year period (1 Jan. 1989 and 31 Oct. 1994) epidermal tests with disinfectants (formalin, sterinol, lysoformin, aldesan, septyl, chloramine, lysol, chlorhexidine) and their components (glutaraldehyd, phenol, hydroquinone) were performed on 322 health service workers examined at the Nofer Institute of Occupational Medicine due to suspected occupational dermatitis. It was found that 89 (27.6%) subjects examined were oversensitive, at least, to one disinfectant, mostly to formalin, sterinol (benzalkonium bromide), lysoformin and chloramine. Frequent occurrence of allergy to metals (nickel, cobalt, chromium, mercury) was observed in persons oversensitive to disinfectants.

Adult↗
PubMed1994

Common industrial processes and occupational irritants and allergens--an update.

This paper reviews the recent development of the industrial processes in the construction, electronics and metal industries which are the predominant industries in developing countries. Common occupational irritants and allergens are presented. The information is essential for occupational dermatologists and physicians managing patients with occupational skin diseases. In the construction industry, the prefabrication construction methods are now widely used. The commonest irritant is cement and the allergens are chromate, rubber chemicals and epoxy resins. In the electronics industry, the commonest irritants include soldering flux, solvent and fibreglass, and allergens include resins and metals, rubber chemicals and amines and colophony. Cutting fluid is the commonest occupational irritant in the metal industry. Biocides and metals in The electro-discharge machining process now widely used in the metal industry for precision engineering uses the electrodischarge machining fluids (EDM fluids) which are a strong skin irritant. Preventive measures including health education are most effective against occupational dermatitis.

Allergens↗
PubMed1994

[Occupational allergy to acrylates--study of cases].

The results of patch tests with an acrylate series (29 chemical compounds) in 8 (3.4%) out of 235 patients with occupational dermatitis were presented. This group of patients consisted of four dentists--prosthodontists and four dental technicians. The following were the most frequent causes of allergy to acrylates: ethylene glycol dimethacrylate (5 positive patch tests), methyl methacrylate (4), 2-hydroxyethyl methacrylate (4), triethylene glycol dimethacrylate. Altogether there were 38 positive patch tests. Over-sensitivity to triacrylates, epoxy acrylate, N,N-methylenebis-acrylamide, urethan derivatives of acrylates and methacrylates was not observed. The most intense skin changes were observed in two prosthodontists involved as well ion general dentistry (deep fissures of digital pulp, trophic changes in nails) allergic to numerous acrylates and methacrylates (one to 14 and the other to 10).

Acrylates↗
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↗
PubMed2000

[Occupational contact dermatitis in women].

In work in which women predominate, the highest rate of the occupational contact dermatitis is seen among hairdressers and medical nursing staffs. Twelve such cases are presented and several points regarding the diagnosis and treatments are discussed. The patients were five hairdressers, two dental technicians, two nurses and three woman divers. A patch test was useful in identifying the allergens or irritants in most cases.

Adolescent↗
PubMed1995

Occupational hand dermatitis in hospital environments.

Health care personnel form the 5th category at major occupational risk of skin disease in Italy. The aim of this study was to assess the prevalence and clinical relevance of contact dermatitis in a group of 1301 employees of the Perugia Monteluce Hospital (658 females and 643 males; mean age 39.8 years) who answered a self-administered questionnaire elaborated by the authors. The subjects with anamnestic hand dermatitis and/or atopic mucosal reactions were clinically examined and submitted to skin tests (patch and/or prick tests). Contact dermatitis of the hands and/or forearms occurred in 21.2% and was significantly more frequent (p < 0.001) in women, subjects under 31 years of age, workers in internistic and surgical fields, cleaners and nurses. In the majority of cases (94.9%), the lesions were irritant in origin and mainly related to disinfectants (especially, chlorhexidine gluconate and glutaraldehyde) and gloves (latex proteins and starch glove powder, rather than accelerators and additives of rubber). Finally, atopy seemed to favour the onset of hand dermatitis. The importance of these results for preventive measures of contact dermatitis in hospital employees is discussed.

Adult↗
PubMed2000

Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA.

Since February 1993 the EPIDERM surveillance scheme has collected data on occupational skin disease from consultant dermatologists in the UK. Reporting by occupational physicians to the scheme began in May 1994 and was superseded in January 1996 by the Occupational Physicians Reporting Activity (OPRA). The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in better targeting efforts to reduce the burden of skin disease at work.

Dermatitis, Occupational↗
PubMed1999

T cell involvement in persulfate triggered occupational contact dermatitis and asthma.

BACKGROUND: Ammonium and potassium persulfates may induce a variety of cutaneous and respiratory diseases. The precise underlying mechanisms, however, are unclear. OBJECTIVE: To describe a hairdresser, who developed contact dermatitis, rhinoconjuntivitis, and bronchial asthma of delayed onset after occupational exposure to hair bleaches containing persulfate salts and to provide evidence for a common T-cell mediated mechanism responsible for the clinical manifestations. METHODS: We performed skin testing, routine histologic and immunohistochemical examination of the skin reaction after prick testing, lymphocyte proliferation analysis, nasal challenge test, and pulmonary function testing. RESULTS: The causative role of bleaching powder and ammonium persulfate was demonstrated by case history, skin tests, and a nasal challenge test. Patch tests produced a delayed cutaneous reaction to ammonium persulfate confirming contact sensitization. Prick tests with bleaching powder and ammonium persulfate were negative at 15 minutes but revealed a late skin reaction with a papule at the prick sites after 24 hours. Histologic examination of this late reaction demonstrated a perivascular infiltration comprising predominantly T lymphocytes. Further, a significant proliferation of T cells to bleaching powder was reproducibly found by a lymphocyte proliferation analysis. Nasal challenge test with bleaching powder showed a significant reduction of air flow after 24 hours. CONCLUSION: Our findings suggest that immunologic mechanism with direct involvement of T cells may not only play an important role in the pathogenesis of the cutaneous but also in the respiratory and rhinoconjunctival reactions.

Adult↗
PubMed1984

Primary and secondary sites of occupational contact dermatitis.

Patterns of distribution of allergic contact dermatitis follow a certain order in time. The disease starts at a given site, most often as a unilateral acrodermatitis and, should it become chronic, spreads locally. The subsequent pattern of distribution varies depending on the primary site and the type--occupational or otherwise--of the disease. In this study data collected two decades ago are confronted with the more recent ones relating to 1055 cases of occupational allergic contact dermatitis. Examination of this material brought to light no essential difference between the older and more recent patterns of distribution of secondary sites. The incidence, however, of certain multiple localizations and of the primary or secondary involvement of the face has diminished.

Dermatitis, Atopic↗
PubMed2002

Occupational contact dermatitis I: incidence and return to work pressures.

Since the passage of the United States Occupational Safety and Health Act (OSHA) in 1970, there have been extensive changes in United States workplaces that should have served to enhance the prevention of occupational skin disease (OSD). Analysis of skin diseases reported to OSHA (OSHA recordables) shows that the number of OSDs declined steadily from 1974 to 1983 to about half the previous annual incidence. After 1984, there was a modest resurgence peaking in 1994, with a subsequent decline. A similar but somewhat greater decline in the late 1990s has been observed for occupational respiratory diseases, diseases caused by toxic agents and for poisonings. Likely explanations for the trends in OSD are discussed; the initial decline probably reflected an improvement in workplace conditions, the later resurgence and decline may have been attributable to changes in recording behaviors and in worker's compensation. The decline in recorded OSD since 1996 has been fairly uniform in most major industrial sectors but has been less marked in agriculture, forestry, and fishing so that this sector has replaced manufacturing in recording the highest incidence rate. In 1999, the incidence rate of recorded OSD was 0.49 per 1,000 workers, which appears to grossly under report the true incidence. OSD now constitutes about 10% of all occupational disease cases. Currently, there is increasing emphasis in corporate and occupational medicine on reducing costs and maintaining productivity as well as in preventing occupational injuries and diseases. This is shown by the trend for a greater proportion of workers with occupational conditions to return to modified duty positions rather than to be completely off work. Implications of this phenomena for management of OSD are discussed.

Dermatitis, Occupational↗
PubMed2005

An epidemic of occupational contact dermatitis from an acrylic glue.

Dermatological examinations were performed in 81 workers involved in the manufacture of electric coils for television displays, who had worked for 4 years in contact with a glue containing isobornyl acrylate, acrylic acid, N,N dimethyleneacrylamide, phosphine oxide, bis(2,6-dimethoxybenzoyl) (2,4,4-trimethylpentyl)- and beta-carboxyethyl acrylate. The glue was cured by 350-500-nm ultraviolet and visible radiations. Acrylate-specific dermal lesions were detected in 21 (25.9%) people. Occupational irritant contact dermatitis was diagnosed in 12 (15%) of the workers and occupational allergic contact dermatitis in 9 (11.2%). 12 people reacted to acrylates. Cross-reactions with methacrylates were not observed. The highest number of positive tests was obtained with triethyleneglycol diacrylate (10 people) and diethyleneglycol diacrylate (9), followed by 1,6-hexanediol diacrylate (5), 1,4-butanediol diacrylate (4), beta-carboxyethyl acrylate (3), tripropyleneglycol diacrylate (2) and pentaerythritol triacrylate (2). No cases of allergy to isobornyl acrylate, N,N-methylenebisacrylamide or phosphine oxide were noted.

Acrylates↗