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Houle MC, Holness DL, DeKoven J. Occupational Contact Dermatitis: An Individualized Approach to the Worker with Dermatitis. CURRENT DERMATOLOGY REPORTS 2021; 10:182-191. [PMID: 34540358 PMCID: PMC8439371 DOI: 10.1007/s13671-021-00339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review To provide an up-to-date, customizable approach to the worker presenting with dermatitis. Recent Findings Occupational contact dermatitis (OCD) is often a result of combined allergic, irritant, and endogenous factors. Potential causes of OCD can be categorized in 3 main groupings: workplace materials, personal protective equipment, and skin care. Although patterns of dermatitis may provide some indication of the etiological factor(s), patch testing remains essential in the diagnosis of allergic OCD. Management of OCD may require changes in workplace practices to reduce worker exposure to the causative agents and improve skin care practices. Summary OCD is a multifaceted condition with significant consequences for affected workers and their families, employers, and insurers. A methodical and individualized approach to the patient with OCD should ensure timely and accurate diagnosis(es).
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Holness DL, Gomez P, Kudla I, Skotnicki S, DeKoven JG. Occupational contact dermatitis: Return to work using a multidisciplinary clinic model. Contact Dermatitis 2021; 85:686-692. [PMID: 34293189 DOI: 10.1111/cod.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/24/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Occupational contact dermatitis often results in work disruption. Return-to-work (RTW) is an important outcome. OBJECTIVE The objective of this study was to determine RTW outcomes and factors associated with such outcomes using a multidisciplinary clinic model. METHODS Chart abstraction was performed for 194 workers who received RTW assistance over a 6-year period. Elements abstracted included demographic and diagnostic information and information about the RTW program including principles, program components, barriers, and facilitators. RESULTS Of the 902 workers seen for dermatologic assessment, 194 received RTW assistance. At initial assessment, 37% were not working because of their skin disease, and at follow-up, 7% were not working because of their skin disease. The RTW plan components included a graduated or trial of RTW, specific recommendations for avoiding exposure, personal protective equipment, skin management, and ongoing skin monitoring. Principles associated with successful RTW included good communication and the availability of modified work and a worker adherence to the plan. Barriers included lack of modified work, unresponsive employers, and ongoing skin problems. CONCLUSIONS Specific approaches are important to identify if RTW is to be successful for workers with occupational contact dermatitis.
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Affiliation(s)
- D Linn Holness
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Pilar Gomez
- Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Irena Kudla
- Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Occupational Medicine Clinic, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sandy Skotnicki
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Joel G DeKoven
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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Holness DL. Occupational Dermatitis and Urticaria. Immunol Allergy Clin North Am 2021; 41:439-453. [PMID: 34225899 DOI: 10.1016/j.iac.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Occupational contact dermatitis is the most common occupational skin disease (OSD), and most of them are irritant in nature. There is less information available about contact urticaria than contact dermatitis. There are several strategies to prevent OSD, although workplace studies suggest there are gaps in their use in the workplace. Because early detection leads to improved outcomes, screening for dermatitis in industries such as health care would be useful. Both diagnosis and management involve 2 components: the actual disease diagnosis and medical treatment and the work-relatedness and management of the workplace to reduce exposures.
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Affiliation(s)
- Dorothy Linn Holness
- Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
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Giménez-Arnau AM, Skudlik C. Occupational Contact Dermatitis: Health Personnel. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Elston DM. Occupational skin disease among health care workers during the coronavirus (COVID-19) epidemic. J Am Acad Dermatol 2020; 82:1085-1086. [PMID: 32171807 PMCID: PMC7156807 DOI: 10.1016/j.jaad.2020.03.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Dirk M Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on occupational contact dermatitis including gaps in knowledge and practice. Occupational contact dermatitis is the most common occupational skin disease. RECENT FINDINGS New sources of exposure for known allergens and new allergens are continually being reported. Through clinical databases and surveillance systems, effects of prevention efforts or introduction of new allergens or new uses of known allergens can be monitored. Though the diagnostic process is clear, there are delays in workers seeking care. As early detection and intervention improves outcomes, screening should be implemented. Gaps in primary prevention in the workplace are identified and should be addressed to reduce the burden of disease. Surveillance systems support the prevention mandate. Understanding limitations of our knowledge and identifying gaps in practice can lead to initiatives to address research and practice needs and improve prevention of occupational dermatoses.
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Affiliation(s)
- Dorothy Linn Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, Canada. .,Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada. .,MAP Centre for Urban Health Solutions, St Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada.
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