Prevention of Occupational Skin Disease

Women's Occupational Dermatologic Issues

With almost 65 million women in the workforce, their representation in various occupational sectors is crucial, as is their health and safety. Female-dominated occupations in health care and cosmetology along with their potential cutaneous exposures are reviewed. Proper evaluation and management are necessary to minimize the disability that can result from these illnesses.

A study of the implementation process of an intervention to prevent work-related skin problems in wet-work occupations

OBJECTIVES

The objective of the present implementation study is to document how an intervention to reduce work-related skin problems by means of implementing an evidence-based skin protection programme in six gut-cleaning departments in swine slaughterhouses was understood, accepted and carried out. The association between the degree of implementation and the reduction of work-related skin problems in each department is examined. The intervention included a top-down strategy with establishment of a management system focusing on skin risks and a bottom-up strategy with participation of a selected group of shop floor workers and the safety representative, as change agents, as well as an empowerment-based educational programme, where the middle management and representatives from the top management also participated.

METHODS

The study design was a randomized controlled intervention study with a 1-year study period. The outcome of the intervention was evaluated by telephone interviews. Data on the implementation process consisted of self-administered questionnaires, focus interviews and compiled written materials. Four indexes referring to the management system and the change agents' intervention activities were constructed. Finally, the Pearson correlation coefficient was used to test the correlation between the degree of implementation and the eczema frequency at 1-year follow-up.

RESULTS

There was a statistically significant association (p < 0.05) between both the index for the combined implementation method and the eczema frequency after 1 year of intervention, and between the activities of the change agents and the eczema frequency. In contrast to this there was only a weak association between the establishment of a formal management system alone and the outcome.

CONCLUSION

The study evidences that a combination of a top-down and a bottom-up implementation method is effective to reduce work-related skin problems, and that the process of implementation is a significant determinant of the overall results.

Correlation of skin phototype with facial wrinkle formation

Facial wrinkle formation is a representative sign of photoaging. Skin can be divided into different skin phototypes (SPTs) depending on its sensitivity to solar radiation. We have determined the relationship between SPTs and deep and fine wrinkle scores on the faces of 230 Japanese subjects. This group was chosen because it is relatively easy to quantify acute and chronic sun damage in Japanese individuals. SPT in the Japanese subjects was classified into one of four groups, SPT-I to -IV according to Fitzpatrick's classification method. The subjects were further classified into indoor or outdoor workers. After photographing the outer canthus, deep and fine wrinkles were discriminated visually and scored from 1-11 and from 1-9, respectively. UV light was used as a photographic light source for clear depiction of the fine wrinkles. Higher scores were recorded for deep wrinkles in individuals with SPT-I, who are more sensitive to sunlight than those with SPT-III or IV, who are more tolerant to sunlight. However, the same tendency did not seem to be apparent for fine wrinkle scores. A high incidence of SPT-IV was seen in outdoor workers. Early detection of SPT-I in individuals who are sensitive to sunlight, may help to predict and prevent photoaging of deep wrinkles. Sensitivity to sunlight may play a part in determining an individual's choice of working environment.

Can pre-employment patch testing help to prevent occupational contact allergy?

175 subjects (157 female, 18 male) were patch tested with a standard series of allergens (Epipharm Allergy Service, GmbH, Linz, Austria), during pre-employment examinations in the pharmaceutical industry, considered an industry at risk for the development of contact sensitization. None of those examined had contact dermatitis prior to testing and none gave a positive history of hand ecczema. Patch testing was positive in 12 (7%) subjects, of whom 7 showed a positive reaction to only 1 contact allergen and 5 reacted to several contact allergens. 5 subjects (2.9%) reacted positively to metal salts (nickel, cobalt, chromium), 5 (2.9%) had a positive skin reaction to mixtures of rubber additives, and the remaining 2 to other allergens.

Occupational contact dermatitis in New South Wales

Five hundred and seventy patients with occupational contact dermatitis (OCD) were seen between 1984 and 1990 at the Skin and Cancer Foundation in Sydney. Data derived from these patients demonstrated that hairdressing, food, construction and the medical industries were the most at risk of OCD. The hairdressing and food industries had a high percentage of apprentices suffering OCD whilst the 35 to 44 year age bracket was most at risk in the construction industry. Allergic contact dermatitis was responsible for 38.2% of cases. The main allergens were chromate, thiuram, epoxy resin, nickel and cobalt. A third (33.9%) of patients were atopic. The average time lost from work was 16 days each year and the calculated yearly cost of OCD in New South Wales was approximately $12 million.