Occupational allergic contact dermatitis caused by wood dusts

Comparison between patch test results of natural dyes and standard allergens in batik workers with occupational contact dermatitis

BACKGROUND

Occupational contact dermatitis (OCD) is a skin disorder caused by contact with any substances found in the workplace. Occupational contact dermatitis is second most common occupational disease (15% of all cases of occupational disease). Occupational contact dermatitis is divided into allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) which is 80% of cases that affects hands. Batik is an art that is painted on cloth, it is one of Indonesian cultural heritage. Batik workers have a higher risk of obtaining OCD due to exposure to chemicals and fluids used during work. Natural dyes used in the dyeing process are less likely to cause ACD than standard allergens. Some of the natural dyes used in the dyeing process in batik industries are Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni) cause skin sensitisation.

OBJECTIVE

To compare the results of patch testing between natural dyes (Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni) with standard allergens (p-phneyldiamine 0.1%, potassium dichromate 0.5% and formaldehyde 0.1%) as a cause of ACD in batik workers in Surakarta, East Java, Indonesia.

METHOD

A cross-sectional study was conducted on 63 subjects batik workers with OCD in Surakarta, East Java, Indonesia. Subjects were patch tested with three standard allergens (p-phenylenediamine 0.1%, potassium dichromate 0.5%, and formaldehyde 1%) and natural dyes (Indigofera tinctoria, sappan wood (Caesalpinia sappan), and Mahagony (Swietenia mahagoni). A closed patch test was evaluated 48 and 96 hour later. Screening of OCD in batik workers in Surakarta, East Java, Indonesia was based on Nordic Occupational Skin Questionnaire NOSQ-2002, and diagnosis of OCD was based on Mathias criteria (at least 4 out of 7 criteria were met). Data were analysed using a non-parametric Chi-square test with SPSS 21 with a significant difference if the p-value < 0.05.

RESULT

Natural dyes significantly caused allergic contact dermatitis in batik workers in Surakarta, East Java, Indonesia than standard allergens (p = 0.016). A positive patch test was found in 11 patients, standard allergen p-phenylenediamine (PPD) 0.1% was seen on one patient, potassium dichromate 0.5% on two patients, and formaldehyde 1% on two patients. A positive patch test using Indigofera tinctoria was found at one patient, sappan wood (Caesalpinia sappan) in three patients, and Mahagony (Swietenia mahagoni) in five patients.

CONCLUSION

Natural dyes cause more positive patch test results in batik workers.

Tectona grandis L.f: A comprehensive review on its patents, chemical constituents, and biological activities

Tectona grandis L.f is a timber plant that is commonly referred to as teak. Its wide use as a medicine in the various indigenous systems makes it a plant of importance. A wide gamut of phytoconstituents like alkaloids, phenolic glycosides, steroids, etc. has been reported. A renewed interest in this plant has resulted in scientific investigations by various researchers towards the isolation and identification of active constituents along with scientific proof of its biological activities. The different parts of the plant have been scientifically evaluated for their antioxidant, antipyretic, analgesic, hypoglycemic, wound healing, cytotoxic, and many more biological activities. Documentation of this scientific knowledge is of importance to have consolidated precise information encompassing the various aspects of this plant, which could provide a base for future studies. This review is a compilation of the salient reports on these investigations concerning phytochemistry, the methods used to identify and quantify the constituents, the evaluation methods of the biological activity, toxicological studies, allergies and the patent/patent applications. This will further help researchers to find an area of the gap for future studies.

Occupational Exposure to Wood Dust and the Burden of Nasopharynx and Sinonasal Cancer in Canada

BACKGROUND

Millions of workers around the world are exposed to wood dust, as a by-product of woodworking. Nasopharynx cancers (NPCs) and sinonasal cancers (SNCs) are two cancers that can be caused by occupational exposure to wood dust, but there is little evidence regarding their burden in Canada.

OBJECTIVE

the aim of this study was to estimate the incidence and economic burden of newly diagnosed cases of NPC and SNC in 2011 in Canada, attributable to occupational exposures to wood dust.

METHODS

calculating the incidence of cancer attributable to occupational exposure involved three steps of defining relative risk, assessing the prevalence of exposure and population modelling. We estimated the lifetime costs of newly diagnosed NPC and SNC from the societal perspective. The three major cost categories that we considered were direct costs (healthcare costs, out-of-pocket costs, and informal caregiving costs), indirect costs (labour productivity/output costs, employer adjustment costs, and home production losses), and intangible costs (health-related quality of life losses). To generate an estimate of economic burden, we used secondary data from multiple sources and applied them to our computational model developed from an extensive literature review.

RESULTS

From approximately 1.3 million workers exposed to wood dust, we expected 28%, 43% and 29% were exposed to low, medium, and high levels, respectively. We estimated from 235 newly diagnosed cases of NPC and 245 newly diagnosed cases of SNC, 4.6% (11 cases) and 4.4% (11 cases) were attributed to occupational exposure to wood dust, respectively. Our estimates of the economic burden of occupational NPC and SNC were about CAD 5.4 million (CAD 496,311 per-case) and CAD 6.7 million (CAD 627,437 per-case), respectively. For NPC direct costs constituted approximately 20% of all costs, and indirect and intangible costs accounted for 55% and 25%, while for SNC the breakdown distribution were 16%, 42% and 42%, respectively.

CONCLUSIONS

Our estimates highlighted the importance of occupational NPC and SNC amongst other occupational cancers, especially in countries with large wood-related industries. This paper also serves the information needs of policymakers who are seeking to make evidence-based decisions about occupational cancer prevention efforts.

Effect of alternative litter materials on the behaviour of male broilers

The welfare of broilers is strongly dependent on the litter material because they spend their life in contact with it. The purpose of this study was to determine the effects of alternative litter materials on broiler behaviour. Two hundred eighty-eight 1-day old male broiler chicks were used. Chicks were placed in pens each having different litter material (Wood shavings (WS), paper waste sludge (PWS), sepiolite (S), the mix of 25% paper waste sludge & 75% sepiolite (25PWS+75 S), the mix of 50% paper waste sludge & 50% sepiolite (50PWS+50 S) and the mix of 75% paper waste sludge & 25% sepiolite (75PWS+25 S)). Broilers in the pens were recorded with a camera on the same day in a week during 6 weeks' trial. When total behaviour was assessed from 1 to 41 days of age, the percentage of sitting behaviour was the highest in the WS group and the percentage of resting behaviour was the lowest in the groups of S and WS. It can be suggested that PWS, which is a waste product, does not have a negative effect on natural behaviour and welfare of broilers and it can be used alone or mixed with S as a litter material.

Environmental impacts, water footprint and cumulative energy demand of match industry in Pakistan

A comprehensive life cycle assessment (LCA) was conducted for the matchsticks industry in the Khyber Pakhtunkhwa province of Pakistan to quantify environmental footprint, water footprint, cumulative energy use, and to identify improvement opportunities in the matchsticks manufacturing process. One carton of matchsticks was used as reference unit for this study. Foreground data was collected from the matchsticks industry through questionnaire surveys, personal meetings, and field measurements. The collected data was transformed into potential environmental impacts through the Centre for Environment Studies (CML) 2000 v.2.05 method present by default in the SimaPro v.9.1 software. Water footprint was calculated using methodology developed by Hoekstra et al., 2012 (water scarcity index) V1.02 and cumulative energy demand by SimaPro v.9.1 software. The results showed that transport of primary material (wood logs), sawn wood for matchsticks, red phosphorous, acrylic varnish, and kerosene fuel oil contributed to the overall environmental impacts. Transport of primary materials and sawn timber for matchsticks contributed significantly to abiotic depletion, global warming, eutrophication potential, ozone depletion, corrosion, human toxicity, and aquatic ecotoxicity effects. The total water footprint for manufacturing one carton of matchsticks was 0.265332 m3, whereas the total cumulative energy demand was 715.860 Mega Joules (MJ), mainly sourced from non-renewable fossil fuels (708.979 MJ). Scenario analysis was also conducted for 20% and 30% reduction in the primary material distance covered by trucks and revealed that reducing direct material transport distances could diminish environmental impacts and energy consumption. Therefore, environmental footprint could be minimized through diverting matchsticks industries freight from indigenous routes to high mobility highways and by promoting industrial forestry close to industrial zones in Pakistan. Many industries did not have emissions control systems, exceeding the permissible limit for emissions established by the National Environmental Quality Standards (NEQS) of Pakistan. Thus, installation of emissions control system could also diminish emissions from match industry in Pakistan.

Floor Substrate Preferences of Chickens: A Meta-Analysis

Environmental enrichment promotes sensory and motor stimulation for species-typical behaviors, which in turn enhance animal well-being. For farmed Galliformes, housing systems often limit enrichment to bedding and litter, that simultaneously act as material for dustbathing and foraging. Therefore, this meta-analysis sought to systematically review and synthesize the substrate preference test literature for Galliformes. Data based on the following four welfare-related behaviors were extracted for analysis: (1) dustbathing, (2) foraging, (3) pecking, and (4) time spent on a given substrate. Literature searches in CAB Direct, Web of Science, and Google Scholar yielded 239 articles, and hand searching yielded an additional five articles. Ten publications that used different chicken strains as test subjects, met the criteria to be included in the systematic review. The effects of bedding type, the number of days birds had access to tested substrates, enclosure area, and substrate area, on the examined behaviors were determined. We found that birds preferred dustbathing in sand and peat moss more than on any other substrates. The bedding type, size of the enclosure, and size of the substrate area affected the amount of time that birds spent on the tested substrates. When provided the choice between bedding materials, birds spent more time on sand or peat moss than on any other substrate or on no substrate. Notably, most studies did not report relevant physical or chemical characteristics of substrate that may influence birds' preferences, such as grain size, moisture content and the level of soiling. Focusing future studies on identifying substrate characteristics that influence preferences can lead to the discovery of new, practical, enriching beddings that can be easily implemented in housing systems for Galliformes.

Broiler Chicks' Motivation for Different Wood Beddings and Amounts of Soiling

Simple Summary

Many animals move excreta—or feces—away from resting areas to avoid attracting predators and spreading disease. However, today’s farms raise broiler (meat) chickens in large barns with stocking densities that prevent the birds from segregating their excreta. Moreover, whether or not chickens would prefer to avoid their excreta is unknown. Understanding what litter conditions chickens prefer can help inform farming practices. Therefore, this experiment aimed to assess chicks’ motivation to access unsoiled bedding or soiled litter. We used six pens of six to seven broiler chicks—each pen divided into two compartments by a barrier containing two one-way push-doors. The ‘home’ compartment contained soiled wood shavings, while the ‘treatment’ (T) compartment contained either aspen wood shavings, pine and spruce wood shavings, soiled pine and spruce wood shavings, ammonia reductant treated soiled pine and spruce wood shavings, or a feed treatment as a gold standard. To determine the chicks’ motivation to access the resources, the door leading into T weighed 0% (lifted), 10%, 20%, or 30% of the chicks’ body weight. The combination of time spent in T, number of visits to T, and average maximum weight pushed to access T were used to measure motivation. Chicks showed equal motivation for all substrates and preferred feed over all substrates. However, future experiments must explore chicks’ preference and motivation over the long-term in commercial conditions.

Abstract

In the wild, excreta soiled surroundings can attract predators and spread disease. Yet, farmers rear broiler chicks in large barns with stocking densities that prevent excreta segregation. To measure chicks’ motivation to access unsoiled bedding or soiled litter (collectively, substrates) we used 40 16-day-old broiler chicks who were divided into six two-compartment pens. The ‘home’ compartment (H) contained soiled wood shavings, while the ‘treatment’ compartment (T) contained either aspen wood shavings, pine and spruce wood shavings, soiled pine and spruce wood shavings, ammonia reductant treated soiled pine and spruce wood shavings, or a feed treatment as a gold standard. The barrier separating the compartments had two one-way push-doors that chicks pushed to access a resource. The chicks’ motivation was measured by the average maximum weight pushed to access each resource. The door leading to T weighed 0% (raised), 10%, 20%, or 30% of the chicks’ body weight, and chicks could return to H via a raised (for 0%) or unweighted door. Our findings indicate that chicks worked hardest for feed, but paid a lower, equal price to access all substrates. With increasing door weight, chicks visited less and spent less time with the substrates. Therefore, as chicks themselves do not avoid litter that could have potential negative effects on their well-being, it is important that farmers diligently monitor litter conditions as their primary care-takers.

Functional disorders of the lung and symptoms of respiratory disease associated with occupational inhalation exposure to wood dust in Iran

OBJECTIVES

The possible adverse respiratory effects of airborne pollutants in sawmills have not been thoroughly investigated in Iran. Additionally, the extent to which workers are exposed to this organic dust and its associated bioaerosols has not been extensively quantified. Likewise, the predominant bacterial and fungal species associated with wood dust have not been characterized. The present study was undertaken to address these issues.

METHODS

One hundred male individuals exposed to wood dust and 100 unexposed male subjects were investigated. They completed a standardized respiratory symptom questionnaire and underwent spirometry testing. Additionally, airborne concentrations of respirable and inhalable dust particles, bacteria, and fungi were measured.

RESULTS

The mean concentrations of inhalable and respirable dust particles, bacteria, and fungi were found to be 2.44, 6.76 mg/m³ , 756.38, and 299.15 colony-forming units/m³ , respectively. The predominant Gram-negative bacteria in the sawmills included the Pseudomonadaceae, Klebsiella pneumoniae, and Rhinoscleromatis spp., and the predominant fungi consisted of the zygomycetes and Aspergillus spp. Respiratory symptoms were significantly more prevalent among exposed workers. Significant cross-shift decrements were noted in some pulmonary function parameters. Similarly, pre-shift spirometry results indicated that some pulmonary function parameters were significantly lower in the exposed group.

CONCLUSIONS

Exposure to wood dust and its bioaerosols was associated with significantly higher prevalence of respiratory symptoms and both acute (i.e., partially reversible) and chronic (i.e., irreversible) decrements in the functional capacity of the lung. Additionally, the characterized bioaerosols did not differ significantly from those isolated in other parts of the world.

Botanicals With Dermatologic Properties Derived From First Nations Healing: Part 1—Trees

Introduction:

First Nations people have a long history of working with medicinal plants used to treat skin diseases. The purpose was to assess the dermatologic therapeutic potential of western red cedar, white spruce, birch, balsam poplar, and black spruce.

Methods:

Based on expert recommendations, 5 trees were selected that were used in First Nations medicine for cutaneous healing and have potential and/or current application to dermatology today. We searched several databases up to June 12, 2014.

Results:

Western red cedar’s known active principal compound, β-thujaplicin, has been studied in atopic dermatitis. White spruce’s known active principal compound, 7-hydroxymatairesinol, has anti-inflammatory activity, while phase II clinical trials have been completed on a birch bark emulsion for the treatment of actinic keratoses, epidermolysis bullosa, and the healing of split thickness graft donor sites. Balsam poplar has been used clinically as an anti-aging remedy. Black spruce bark contains higher amounts of the anti-oxidant trans-resveratrol than red wine.

Discussion:

North American traditional medicine has identified important botanical agents that are potentially relevant to both cosmetic and medical dermatology. This study is limited by the lack of good quality evidence contributing to the review. The article is limited to 5 trees, a fraction of those used by First Nations with dermatological properties.

Refined Spruce Resin to Treat Chronic Wounds: Rebirth of an Old Folkloristic Therapy

Significance: The treatment of chronic wounds results in an enormous drain on healthcare resources in terms of workload, costs, frustration, and impaired quality of life, and it presents a clinical challenge for physicians worldwide. Effective local treatment of a chronic wound has an important role, particularly in patients who are-because of their poor general condition, diminished life expectancy, or unacceptable operative risk-outside of surgical treatment. Recent Advances: Since 2002, our multidisciplinary research group has investigated the properties of Norway spruce (Picea abies) resin in wound healing and its therapeutic applications in wound care. Resin is a complex mixture of resin acids (e.g., abietic, neoabietic, dehydroabietic, pimaric, isopimaric, levopimaric, sandrakopimaric, and palustric acids) and lignans (e.g., pino-, larici-, matairesinol, and p-hydroxycinnamic acid) having substantial antimicrobial, wound-healing, and skin regeneration enhancing properties. Critical Issues: The cornerstone in successful wound care is an efficient causal treatment of the underlying co-morbidities, for example, diabetes, malnutrition, vascular- or certain systemic diseases. However, definitive diagnosis and specific therapy of a chronic wound is often difficult, because the etiology is practically always multi-factorial, and in the chronic phase, confounding factors such as infections invariably impede wound healing. Future Directions: To study the exact molecular mechanism of actions by which resin promotes cellular regeneration and epithelialization during the wound-healing process. To investigate potential antimicrobial properties of resin against the most ominous multidrug-resistant beta-lactamase (including carbapenemases and metallo-β-lactamases) producing bacteria, and to individualize those pharmacologically active compounds which are responsible for the antimicrobial activity of resin.

Chemical markers of occupational exposure to teak wood dust

A novel high-performance liquid chromatographic/ultraviolet method was developed to detect lapachol (LP) and deoxylapachol (DLP) in wood dust as chemical markers of teak wood (a suspected human carcinogen). The specificity of this analysis was determined by noting the absence of LP and DLP in 12 other specimens of different woods belonging to the angiosperm family. The consistency was examined by analyzing teak from three different sources, where the percentages (wt/wt) of the chemicals ranged from 0.006 to 0.261 for LP and from 0.038 to 0.497 for DLP, respectively. Although the LP and DLP components of teak varied according to source, a very high correlation coefficient (r (2) > 0.98 always) was found between the content of the two markers in the bulk specimens and in bulk dust derived from them. The method was then applied to teak dust collected on polyvinylchloride filters from aerosol in an exposure chamber in the range of mass loadings between 0.03 and 3.65 mg, which corresponds to a dust exposure between 0.124 and 8.703 mg m(-3) for a sampling time of 2h. A field test was also carried out in a small factory where teak was used. A good correlation was confirmed between LP and DLP versus the dust collected on the filter in both cases. LP and DLP can be markers to estimate the true quantities of teak dust inhaled in a workplace with mixed wood dust, provided the results are matched to the content of LP and DLP in the bulk wood. LP and DLP have also been proposed as the agents responsible for allergic reaction to teak dust. Therefore, it would be useful to evaluate the exposure to these two substances even without a relationship to teak dust exposure.

Natural coniferous resin salve used to treat complicated surgical wounds: pilot clinical trial on healing and costs

Resin is a natural product of coniferous trees. Salves manufactured from spruce resin (Picea abies) have been used for centuries to treat wounds and skin infections. We report a pilot clinical trial designed to investigate healing rates, factors that contribute to delayed wound healing, cost-effectiveness, and incidence of allergic reactions when resin salve is used to treat complicated surgical wounds. The trial involved 23 patients in whom wound healing after surgery was delayed. These patients were assigned to resin salve treatment. The primary outcome measure was the number of days to complete wound healing. Secondary objectives included an assessment of factors contributing to delayed wound healing, an estimation of associated costs, and an investigation into the occurrence of allergic reactions related to resin salve therapy. The study achieved a healing rate of 100%. The mean ± SD healing time was 43 ± 24 days. The mean ± SD wound size (length × width × depth) was (29 ± 19) × (12 ± 7) × (4 ± 3) mm. Wound size, use of corticosteroids or other immunosuppressants, and immobilization were statistically significant (P < 0.05) contributors to delayed wound healing and impaired re-epithelialization. The total mean ± SD costs of the resin salve treatment were €45.0 ± 26.0 per patient during the entire treatment period and €1.2 ± 0.5 per treatment day. The rate of allergic reactions was 0%. The results of this pilot trial indicate that complicated surgical wounds may be treated successfully with resin salve. The treatment method is clinically effective and cost-effective, and the rate of allergic reactions is low.

In vitro fungistatic effects of natural coniferous resin from Norway spruce (Picea abies)

Resins (rosin, pitch) are natural products of the coniferous trees and are antimicrobial against a wide range of microbes. The antifungal effectiveness of resin, purified from Norway spruce (Picea abies), was studied against human pathogenic fungi and yeasts with the agar plate diffusion tests and electron microscopy (EM). The fungistatic effect of these resin mixtures (resin salves) was tested against a set of Candida yeasts, dermatophytes, and opportunistic fungi. Transmission and scanning EM was done from samples of fungi (Trichophyton mentagrophytes). In agar diffusion tests, the resin was strongly antifungal against all dermatophytes tested, e.g., against all fungi of the genus Trichophyton, but it was not antifungal against the Candida yeasts or against the opportunistic fungi tested. According to EM, resin caused damages in the cell hyphae and cell wall structures. We conclude that, in the agar plate diffusion test, coniferous resins are strongly fungistatic against the dermatophytic fungi only.

Occupational asthma due to exposure to chengal wood dust

BACKGROUND

Chengal is a resistant rainforest hardwood that is commonly used in South-East Asia for the construction of boats, bridges, house structures and furniture. It contains oligostilbenoids, phenolics, quinones and resins.

AIMS

To describe a case of occupational asthma (OA) related to chengal wood dust.

METHODS

The patient was evaluated clinically for asthma in relation to occupational history, serial peak flow monitoring and specific inhalation challenge (SIC) test.

RESULTS

Peak flow monitoring showed significant deterioration during exposure to chengal wood dust at work. SIC test resulted in an isolated immediate asthmatic reaction.

CONCLUSIONS

Exposure to chengal wood dust can lead to OA and possibly rhinitis. The underlying mechanism should be investigated.

Beneficial effect of resin salve in treatment of severe pressure ulcers: a prospective, randomized and controlled multicentre trial

BACKGROUND

Resin salve of the Norway spruce (Picea abies) has been used in folk medicine to heal wounds and infections.

OBJECTIVES

To study its clinical effectiveness in the treatment of pressure ulcers of the skin.

METHODS

A prospective, randomized, controlled multicentre trial involving 37 patients with grade II-IV pressure ulcers in 11 primary care hospitals was carried out between 2005 and 2007. The ulcers were randomly allocated to receive either resin salve or sodium carboxymethylcellulose hydrocolloid polymer treatment. The inclusion criterion was grade II-IV pressure ulcer. Exclusion criteria were a life expectancy of less than 6 months or a malignant disease. The primary outcome measure was complete healing of the ulcer within 6 months. Secondary outcome measures were partial healing of the ulcer, and successful eradication of bacterial strains cultured from the ulcers at study entry.

RESULTS

Thirteen patients of the resin group and nine patients of the control group completed the 6-month trial. All ulcers healed in 12 of the 13 patients (92%) in the resin group and in four of the nine patients (44%) in the control group (P=0.003; power 73%). Complete healing of the ulcers over time was significantly more common in the resin group than in the control group (P=0.013). Bacterial cultures from the ulcer area more often became negative within 1 month in the resin group.

CONCLUSIONS

Traditional resin salve is significantly more effective in the treatment of infected and noninfected severe pressure ulcers than cellulose polymer gauzes.

An update on airborne contact dermatitis: 2001-2006

Reports on airborne dermatoses are mainly published in the context of occupational settings. Hence, in recent years, dermatologists and also occupational physicians have become increasingly aware of the airborne source of contact dermatitis, resulting mainly from exposure to irritants or allergens. However, their occurrence is still underestimated, because reports often omit the term 'airborne' in relation to dust or volatile allergens. For the present update, we screened the journals 'Contact Dermatitis' (July 2000 to December 2006); 'Dermatitis', formerly named 'American Journal of Contact Dermatitis'; 'La Lettre du Gerda' (January 2000 to December 2006); and also included relevant articles from other journals published during the same period. This resulted in an updated list of airborne dermatitis causes.

Inflammatory response and genotoxicity of seven wood dusts in the human epithelial cell line A549

Exposure to wood dust is common in many workplaces. Epidemiological studies indicate that occupational exposure to hardwood dusts is more harmful than to softwood dusts. In this study, human epithelial cell line A549 was incubated with well-characterized dusts from six commonly used wood species and from medium density fibreboard (MDF), at concentrations between 10 and 300microg/ml. After 3 and 6h of incubation, genotoxicity was assessed by measurement of DNA damage with the single-cell gel electrophoresis (comet) assay and inflammation was measured by the expression of IL-6 and IL-8 mRNA and by the amount of IL-8 protein. There was a 1.2-1.4-fold increase in DNA strand breaks after incubation with beech, teak, pine and MDF dusts compared with the levels in untreated cells, but after 6h only the increase induced by the MDF dust remained. Increased expression of cellular IL-6 and IL-8 mRNA was induced by all of the wood dusts at both times. Similar to IL-8 mRNA expression, the amounts of secreted IL-8 protein were elevated, except after incubation with oak dust, where a marginal reduction was seen. On the basis of the effects on IL-8 mRNA expression, the wood dusts could be divided into three groups, with teak dust being the most potent, MDF, birch, spruce and pine being intermediate, and beech and oak being the least potent. The induction of DNA strand breaks did not correlate well with the interleukin response. In conclusion, all wood dusts induced cytokine responses, and some dusts induced detectable DNA damage. The inflammatory potency seemed intermediate for dusts from the typical softwoods spruce and pine, whereas the dusts from species linked to cancer, beech and oak, were the least inflammatory. The variation of the effects induced by different wood dusts over time indicates that the DNA damage was not secondary to the cytokine response. Although hardwoods are often considered more harmful than softwoods by regulatory agencies, the current experiments do not provide evidence for a clear-cut distinction between toxicities of hardwood and softwood dust.

Allergische Kontaktdermatitis durch Kolophonium und Terpentin in Harzen unbehandelter Kiefernholzmöbel

Pine wood is one of the most used raw products in furniture manufacturing in Europe. High concentrations of colophony and turpentine can be extracted from pine resins. A 45-year-old woman developed a contact dermatitis of the face and hands due to a sensitization to colophony and turpentine after she had bought untreated pine chairs. The increased use of untreated pine in the furniture industry might result in an increase of colophony and turpentine-induced contact allergies. Therefore, the slogan "untreated=harmless" should be considered critically in such cases.

Allergic contact dermatitis to plants in a Spanish dermatology department: a 7-year review

To investigate the incidence of allergic contact dermatitis (ACD) to plants in our area, we reviewed the records of the patients that were studied in the Allergic Contact Unity of our hospital in the last 7 years (2248 patients). We found 69 cases of positive patch tests to plant allergens, representing 3% of all the patients in that period. Diallyl disulfide was the most frequent allergen (47 cases), involving mainly middle-aged housewives with chronic hand eczema. Positive tests to sesquiterpene lactone mix (SL mix) were found in 11 patients, mostly middle-aged rural workmen with an airborne clinical pattern. Other allergens detected were lichens, primin, tulipalin A and wood. These results show a high incidence of ACD to diallyl disulfide that, in our opinion, should be tested in all housewives or cooks with chronic hand eczema. The predominance of the classical airborne pattern of allergy to SL in our study may be because the airborne way of allergen exposure in our area, with a high percentage of rural population, is the most frequent, and it makes it important to remember this possibility in the differential diagnosis of photosensitivity.

Anaphylaxis to Cyphomandra betacea Sendth (tamarillo) in an obeche wood (Triplochiton scleroxylon)--allergic patient

BACKGROUND

Anaphylaxis after the first exposure to a food allergen is uncommon unless a cross-reaction is present.

OBJECTIVE

To investigate a possible relationship between the fruit Cyphomandra betacea Sendth (commonly known as tamarillo) and the wood of Triplochiton scleroxylon (obeche) in a patient with allergic occupational bronchial asthma due to obeche wood who began to experience anaphylaxis episodes after eating tamarillo.

METHODS

A 33-year-old carpenter exposed to obeche wood in his occupation was initially seen with rhinitis and bronchial asthma. The causal relationship of these symptoms to obeche wood exposure was investigated by means of peak flow monitoring and bronchial inhalation testing. Furthermore, the patient had 2 acute episodes of anaphylaxis a few minutes after eating salad containing tamarillo. He had never tasted tamarillo before. The allergologic study included skin prick tests, serum specific IgE determinations, bronchial challenges, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting.

RESULTS

Results of skin prick tests with common aeroallergens were negative. Strong skin prick test responses were obtained with obeche and tamarillo. Results of bronchial challenge testing with obeche extract were positive. In tamarillo extract, a 28-kDa band appeared as the most relevant IgE-binding antigen. A similar band of 28 kDa happens to be frequently detected in obeche-allergic patients.

CONCLUSION

To our knowledge, this is the first reported case of anaphylaxis to tamarillo presented in a patient allergic to obeche, which raises the question of a new cross-reactivity antigen.

Characterization of oak and birch dust-induced expression of cytokines and chemokines in mouse macrophage RAW 264.7 cells

Occupational exposure to wood dust is related to several respiratory diseases, such as allergic rhinitis, chronic bronchitis, and asthma. However, virtually nothing is known about molecular mechanisms behind wood dust-induced pulmonary inflammation. To elucidate the effects of wood dust exposure on cytokine and chemokine expression in murine macrophage cell line cells, mouse RAW 264.7 cells were exposed to two selected hardwood dusts, oak and birch. TiO2 and LPS were used as controls. Expression patterns of several cytokines, chemokines, and chemokine receptors were assessed by real-time quantitative PCR system and by ELISA. Exposure to birch dust caused a major increase in TNF-alpha and IL-6 protein levels whereas a weaker induction of TNF-alpha protein was found after exposure to oak dust. Inorganic TiO2 dust did not induce significant cytokine expression. With respect to the chemokines, a dose-dependent, about 10-fold induction of CCL2 mRNA and protein was found after exposure to birch dust. Oak dust induced weakly CCL2 protein. Similarly, birch dust induced a strong expression of CCL3, CCL4, and CXCL2/3 mRNA whereas only moderate levels of these chemokine mRNAs were detected after oak dust exposure. In contrast, expression of CCL24 mRNA was inhibited by more than 40-fold by both oak and birch dusts. TiO2 dust induced about five-fold expression of CCL3 and CCL4 mRNA but did not affect significantly other chemokines. These results suggest that exposure to birch or oak dusts may influence the development of the inflammatory process in the airways by modulating the expression of macrophage-derived cytokines and chemokines.

Chemical exposure and symptoms of hand dermatitis in construction painters

Studies on the prevalence of hand dermatitis in construction painting are rare. Our aim was to study the painters' chemical exposure and the prevalence of self-reported skin symptoms on hands and forearms. A cross-sectional questionnaire survey was conducted on 1000 Finnish male construction painters and 1000 carpenters (response rates 60.6% and 60.4%, respectively). We used 2 definitions for symptom-based hand dermatitis (liberal > or = 2 symptoms and strict criteria > or = 3) and logistic regression analysis, adjusted with age and atopy. Painters reported more symptoms of hand dermatitis than carpenters (12-month prevalence 22.5% and 14.2%, P < 0.05; strict criteria 13.3% and 6.4%, P < 0.05). A dose-response relationship was found for reporting symptoms and exposure to several solvent-based (SB) and water-based (WB) products. When exposure was combined into 1 variable, daily use of SB epoxy/urethane paints (OR 5.3, 95% CI 2.2-12.9; strict criteria 6.8, 2.3-19.9) and WB putties/plasters (1.9, 1.2-3.0; strict criteria 2.0, 1.1-3.9) were associated with hand dermatitis, whereas using only WB paints was not a risk factor. In conclusion, painters reported significantly more symptoms of hand dermatitis than carpenters. Putties/plasters emerged as a risk factor for dermatitis in construction painting.

[Dermatologic occupationally relevant type I allergies]

In Germany the most frequent initial report of occupational disease is due to occupational skin diseases ("Berufskrankheitenanzeige nach Nr. 5101 der Berufskrankheitenverordnung") defined as "severe or recurrent skin diseases that force the discontinuation of any activity that causes or that could be causing the development, the worsening, or the recurrence of the skin disease". The majority of these occupational skin diseases consists of irritant and allergic contact dermatitis. In contrast, work place- related Type I allergy (contact urticaria syndrome) is less frequent, but carries the risk of systemic reactions. The clinical manifestations and pattern of exposure to Type I allergens in the work place are described.