[Efficacy of the use of barrier creams in the prevention of dermatological diseases in textile dyeing and printing plant workers: results of a randomized trial]

A total of 942 workers of 13 dyeing and printing factories in the area of Como (N. Italy) were examined in order to detect skin complaints on the hands and forearms. Of these, 868 were eligible for and consented to participate in a controlled and randomized experiment aimed at assessing the efficacy of using barrier creams in practical circumstances. 657 workers underwent all three control examinations arranged over about one year. In the randomized group for treatment with barrier creams the cumulative incidence of objective skin lesions was significantly lower than in the group in which no particular recommendation of use was made (44.5% versus 54.4% positive for objective examination in at least one of the three control examinations after recruitment: 95% confidence limits of the difference between 2%-17% percentages; 39.9% versus 47.0% in subjects who were negative at the recruitment examination, 59.0% versus 76.8% in subjects who were positive at the recruitment examination). The use of a hydrocarbon cream was significantly more effective than using a silicone cream (95% confidence limits of the differences of cumulative incidences: -10.9% +20.7% comparing silicone creams with non-treatment; 2.8%-20.2% comparing hydrocarbon creams with non-treatment).

[Prevalence and etiology of occupational dermatoses in workers of railway transport in 1958-1992]

Dermatoses are among the most prevalent occupational diseases on the railway transport; in 1961-1975 their share in total morbidity was 40%. The structure of diseases was as follows (%): contact dermatosis 87.4, eczema 6.8, allergic drug-induced dermatitis 1.4, folliculitis, toxicoderma, chemical burns, radial dermatitis and other kinds of dermatosis 0.84. The main causes of diseases were the use of many chemicals in transport processes and of Diesel engines on trains.

Nickel sensitivity and occupational skin disease

One of the earth's most common metals, nickel, is present in items ranging from uniform buttons to semiconductors. Nickel also represents the most frequently occurring contact allergen. This chapter describes numerous ways that nickel is used industrially and details the clinical features, diagnosis, and prevention of this sensitivity.

An epidemiological study on cutaneous diseases of agricultural workers authorized to use pesticides

BACKGROUND

There is an increased risk for agricultural workers to acquire skin problems, but data so far published are still very scarce.

OBJECTIVE

To individualize skin disorders that involved this class of workers.

METHODS

Between 1990 and 1992, 426 agricultural workers, authorized to use pesticides, were examined. The control group consisted of 100 nonagriculture workers, who were age and sex matched.

RESULTS

Some common dermatological diseases, such as vitiligo, psoriasis and seborrheic dermatitis, had an incidence overlapping with that found in the controls. Irritant plant dermatoses (2.5%), episodes of acute systemic intoxication from pesticides (6.8%), onychopathies due to chronic trauma (16%), contact dermatitis of the hands (12%), chilblains (7%) and Favre-Racouchot syndrome (2.5%) showed a higher prevalence in the study group.

CONCLUSION

Farmers were affected mainly by diseases caused by the direct action of chemical agents, either natural or industrial, in addition to climatic and physical agents.

Prevention of epoxy resin dermatitis: failure of manufacturers to use available research information

Research information is often recommended as a solution for occupational disease and injury. This study asks whether publicly available research information on prevention of a well-documented occupational hazard is acted on by an important sector in industry. The hazard, allergic contact dermatitis (ACD) caused by epoxy resins in paints, is particularly significant for painters, who may have to leave their jobs as a consequence of the condition. No evidence is found, according to a priori criteria, that paint manufacturers/suppliers acted on known prevention measures for epoxy resin ACD that are within their control to implement. The findings suggest that availability of research information alone fails to solve health and safety problems. Recommendations for avenues of direct and indirect enforcement where voluntary implementation is absent in the painting industry are suggested.

[The skin and the environment]

The skin is in such continuous and intimate interaction with environmental influences as no other organ. Environment comes in contact with the organism in the form of substances or forces (physical, chemical, biological) and via different routes: irradiation (electromagnetic irradiation, often referred to in a simplified way as "light"), air, food, direct contact with the skin, injection, or psychosocial interactions. All these influences can lead to disease under certain conditions and in certain individuals, and especially to skin disease. The critical factors are the dose, the mode and time of contact; this is evident with regard to sunlight and its acute and chronic effects. Not only for noxious chemicals are the classification and differentiation of primary toxic reactions from hypersensitivity reactions of predisposed individuals crucial. Hypersensitivity reactions can either be immunologically mediated (allergic) or non-immunological (idiosyncrasy, pseudo-allergy). The existence of a genetic disposition does not exclude the importance of environmental factors. Atopic eczema is an example of a disease that can be influenced dramatically by a variety of environmental factors. Many toxic environmental factors are known to induce skin changes long before systemic or life-threatening diseases appear. The skin can be regarded as a "signal organ" for possible noxious environmental influences. Increased research efforts in this field are mandatory.

Chromium content in human skin after in vitro application of ordinary cement and ferrous-sulphate-reduced cement

The amount of chromium found in human skin after in vitro application of cement suspensions on full-thickness human skin in diffusion cells was investigated. Cement suspensions made from ordinary Portland cement or Portland cement with the chromate reduced with added ferrous sulphate were used. The cement suspensions were either applied on the skin surface under occlusion for 48 h or applied repeatedly every 24 h for 96 h. No statistically significant difference in chromium content of skin layers between skin exposed to ordinary Portland cement, skin exposed to cement with added ferrous sulphate and unexposed skin was observed, despite a more permeable skin barrier at the alkaline pH of the cement suspensions, i.e., pH 12.5. Increased chromium levels in epidermis and dermis were seen when ordinary Portland cement was applied as a suspension with added sodium sulphate (20%) on the skin surface for 96 h. The content of water-soluble chromium in ordinary Portland cement may vary due to the alkali sulphate content of the cement.

Carvone: an overlooked contact allergen cross-reacting with sesquiterpene lactones?

The terpene l-carvone is one of the main constituents of spearmint oil. The sensitizing potential of l-carvone has been considered low, but it has occasionally caused contact allergy in users of spearmint toothpaste and chewing gum. l-Carvone is also an oxidation product of d-limonene that occurs in solvents used increasingly in industry. We included l-carvone 5% pet. in the standard patch test series. In the 1st year, 541 patients were tested and 15 (2.77%) had positive, and 12 doubtful positive (?+) reactions to l-carvone. The strongest reactions were observed in 9 patients with concomitant Compositae sensitivity. The key clinical features and other contact allergies of the patients are presented. When re-testing with l-carvone in the same or lower concentrations, only 2 out of 8 patients had positive reactions. Possible reasons for this discrepancy are discussed in terms of cross-reactions, concomitant sensitization, excited skin syndrome, irritancy and facilitated immunological response.

Exposure, skin protection and occupational skin diseases in the glass-fibre-reinforced plastics industry

A total of 100 workers, 86 from the glass-fibre-reinforced plastics (GRP) industry, 11 from polystyrene production and 3 from polyester resin coating manufacture, were examined for occupational skin hazards and for evaluation of skin protection. The workers had been exposed to many chemicals. Those working in the GRP industry had also been exposed to glass fibre and to dust produced by finishing work. 94% used protective gloves. 22 workers, all employed in the GRP industry, had contracted occupational skin disorders. 6 had allergic and 12 irritant contact dermatitis. 4 workers had an accidental injury caused by a peroxide catalyst, fire, hot air and constant mechanical friction. Allergic dermatoses were due to natural rubber (latex) (4 cases) in protective gloves, phenol-formaldehyde resin (1 case) and cobalt naphthenate (1 case). Irritant hand dermatoses (5 cases) were caused by the combined hazardous effect of unsaturated polyester or vinyl ester resins, organic solvents, glass fibre and dust from finishing work on the skin. Other cases of irritant dermatoses (7 cases) were due to the dust, promoted by mechanical friction of clothes. Skin disorders in the GRP industry were common (26%) but the symptoms were mild and only 3 patients had been on sick leave because of occupational skin disease.

Allergic contact dermatitis from para-tertiary-butylphenol-formaldehyde resin (PTBP-F-R) in Northern Ireland

Over the past 5 years, 2270 patients with suspected allergic contact dermatitis were patch tested in our clinic to the European standard series of allergens. 7 patients (0.3%) showed a positive reaction (> or = +) to PTBP-F-R. In 3 (42.9%) of these patients, the allergen was traced to adhesives but no allergen source was determined in the remainder (57.1%). On the basis of these findings, it is questionable whether PTBP-F-R alone should routinely be included in the European standard series.

Latex gloves: friend or foe?

As healthcare providers, CRNAs must consult with experts and have them address any of the relevant symptoms experienced in the practice of our profession. We must demand that our employer provide us with the best quality gloves/devices with acceptable barrier properties from reputable manufacturers. CRNAs should not use gloves or medical devices if they are unfamiliar with the manufacturer of the product, there is no information on the content of the product, or they do not know if the product meets federal requirements. Practice safety!

Dermatitis in workers exposed to antimony in a melting process

An employee at a brazing rod manufacturing plant developed a generalized eruption of follicular papules and pustules. His job tasks included breaking up antimony ingots and melting the pieces in a crucible; he was exposed to antimony metal dust and to antimony trioxide fumes. Two fellow employees who later performed the same job tasks developed similar eruptions. The clinical and workplace evaluations suggested that the fumes from melting antimony were the cause of the dermatoses, and that the current Occupational Safety and Health Administration permissible exposure limit is not adequate to prevent cutaneous effects of antimony exposure.

Dermatitis on construction sites

Safety has been the main focus of the current drive to improve standards within the construction industry, however, following a survey on dermatitis among construction workers, Peter Mattison found that occupational health issues have been equally neglected.

Contact dermatitis from dielectric fluids in electrodischarge machining

We report an outbreak of irritant contact dermatitis in the aerospace industry from electrodischarge machining (EDM). 20 workers doing EDM developed irritant contact dermatitis from the dielectric fluid used in EDM, a form of precision metal machining that is widely used in mould making and precision engineering. Dielectric fluid contains hydrocarbons that are aromatic, paraffinic or naphthenic and are skin irritants. Irritant contact dermatitis from dielectric fluid has not been reported previously. EDM will become more widespread and occupational dermatitis from dielectric fluid is likely to become more prevalent in the future. Our experience was that irritant contact dermatitis from dielectric fluid can be prevented by simple preventive measures such as personal hygiene and health education.

[UV cured acrylates--potent contact allergens in the occupational environment]

Allergic contact dermatitis is still an important disease in occupational medicine. Acrylic compounds are known to be potent contact sensitizers causing allergic eczema after occupational exposure. To illustrate the problem and the need for preventive arrangements the authors present an unusual clustering of allergic contact dermatitis in three technicians who produced hearing aids using ultraviolet cured akrylate compounds. All three technicians developed eczema on their fingers few months after introduction of the new acrylate compounds in the production. Skin patch testing with the products confirmed that sensitization.

[The prevention of skin diseases in workers in the manufacture of enzyme preparations]

Skin diseases, mainly, allergodermatoses, mycoses and pustular lesions are registered in most workers of the enzyme production. The authors recommend hygienic and therapeutic-prophylactic measures including complexes of antirecurrence therapy which allow to reduce the number of skin diseases in workers of the enzyme industry.