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Sonday Z, Baatjies R, Mwanga HH, Jeebhay MF. Prevalence of work-related skin symptoms and associated factors among tertiary hospital workers exposed to cleaning agents in Southern Africa. Contact Dermatitis 2023; 89:178-189. [PMID: 37401107 PMCID: PMC10530256 DOI: 10.1111/cod.14374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Working with cleaning products is associated with occupational contact dermatitis in health workers (HWs), but information on predictors for these outcomes is limited. OBJECTIVES This study investigated the prevalence of work-related skin symptoms (WRSS) and associated factors in HWs exposed to cleaning agents in two Southern African tertiary hospitals. METHODS A cross-sectional study of 697 HWs used an interviewer-administered questionnaire and assessed for atopy using Phadiatop. RESULTS HWs' median age was 42 years, 77.0% were female and 42.5% were atopic. The prevalence of WRSS in the last 12 months was 14.8%, 12.3% had probable contact dermatitis (PCD) and 3.2% had probable contact urticaria (PCU). Technicians (ORadj 3.91) and tasks involving cleaning and disinfection of skin wounds (ORadj 1.98) were associated with WRSS in the past year. Factors associated with PCD included sterilizing instruments, disinfecting skin before procedures and use of wound adhesives. Factors associated with PCU included specimen preparation using formalin, medical instrument sterilization tasks, and skin/wound cleaning and disinfection. Appropriate glove use when performing patients' skin/wound care was protective against WRSS. CONCLUSIONS Tasks involving cleaning and disinfecting patients' skin and wounds were associated with WRSS in HWs, especially when performed without gloves.
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Affiliation(s)
- Zahida Sonday
- Occupational Medicine Division, School of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Roslynn Baatjies
- Occupational Medicine Division, School of Public HealthUniversity of Cape TownCape TownSouth Africa
- Department of Environmental and Occupational Studies, Faculty of Applied SciencesCape Peninsula University of TechnologyCape TownSouth Africa
| | - Hussein H Mwanga
- Occupational Medicine Division, School of Public HealthUniversity of Cape TownCape TownSouth Africa
- Department of Environmental and Occupational Health, School of Public Health and Social SciencesMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Mohamed F Jeebhay
- Occupational Medicine Division, School of Public HealthUniversity of Cape TownCape TownSouth Africa
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2
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Alghader MRM, Valvi D, de la Hoz RE. Transmission and Risk Factors of COVID-19 among Health Care Workers. Semin Respir Crit Care Med 2023; 44:340-348. [PMID: 37015285 DOI: 10.1055/s-0043-1766118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics.
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Affiliation(s)
- Majdi R M Alghader
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rafael E de la Hoz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
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3
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Kobos L, Anderson K, Kurth L, Liang X, Groth CP, England L, Laney AS, Virji MA. Characterization of Cleaning and Disinfection Product Use, Glove Use, and Skin Disorders by Healthcare Occupations in a Midwestern Healthcare Facility. BUILDINGS (BASEL, SWITZERLAND) 2022; 12:10.3390/buildings12122216. [PMID: 38650891 PMCID: PMC11034745 DOI: 10.3390/buildings12122216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Healthcare facility staff use a wide variety of cleaning and disinfecting products during their daily operations, many of which are associated with respiratory or skin irritation or sensitization with repeated exposure. The objective of this study was to characterize the prevalence of cleaning and disinfection product use, glove use during cleaning and disinfection, and skin/allergy symptoms by occupation and identify the factors influencing glove use among the healthcare facility staff. A questionnaire was administered to the current employees at a midwestern Veterans Affairs healthcare facility that elicited information on cleaning and disinfection product use, glove use during cleaning and disinfection, skin/allergy symptoms, and other demographic characteristics, which were summarized by occupation. The central supply/environmental service workers (2% of the total survey population), nurses (26%,), nurse assistants (3%), and laboratory technicians (5%) had the highest prevalence of using cleaning or disinfecting products, specifically quaternary ammonium compounds, bleach, and alcohol. Glove use while using products was common in both patient care and non-patient care occupations. The factors associated with glove use included using bleach or quaternary ammonium compounds and using cleaning products 2-3 or 4-5 days per week. A high frequency of glove use (≥75%) was reported by workers in most occupations when using quaternary ammonium compounds or bleach. The use of alcohol, bleach, and quaternary ammonium compounds was associated with skin disorders (p < 0.05). These research findings indicate that although the workers from most occupations report a high frequency of glove use when using cleaning and disinfection products, there is room for improvement, especially among administrative, maintenance, and nursing workers. These groups may represent populations which could benefit from the implementation of workplace interventions and further training regarding the use of personal protective equipment and the potential health hazards of exposure to cleaning and disinfecting chemicals.
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Affiliation(s)
- Lisa Kobos
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Kim Anderson
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Laura Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Caroline P. Groth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26505, USA
| | - Lucy England
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - A. Scott Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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Cocco P. Time for Re-Evaluating the Human Carcinogenicity of Ethylenedithiocarbamate Fungicides? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2632. [PMID: 35270318 PMCID: PMC8909994 DOI: 10.3390/ijerph19052632] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND In January 2021, the European Union ended the license of Mancozeb, the bestselling ethylenedithiocarbamate (EBDC) fungicide, because of some properties typical of human carcinogens. This decision contrasts the IARC classification of EBDC fungicides (Group 3, not classifiable as to human carcinogenicity). A systematic review of the scientific literature was conducted to explore the current evidence. METHODS Human and experimental studies of cancer and exposure to EBDC fungicides (Mancozeb, Maneb, Zineb, and others) and ethylene thiourea (ETU), their major metabolite, published in English as of December 2021, were retrieved using PubMed, the list of references of the relevant reports, and grey literature. RESULTS The epidemiological evidence of EBDC carcinogenicity is inadequate, with two studies each suggesting an association with melanoma and brain cancer and inconsistent findings for thyroid cancer. Experimental animal studies point at thyroid cancer in rats and liver cancer in mice, while multiple organs were affected following the long-term oral administration of Mancozeb. The mechanism of thyroid carcinogenesis in rats has also been shown to occur in humans. Genotoxic effects have been reported. CONCLUSIONS The results of this systematic review suggest inadequate evidence for the carcinogenicity of EBDC fungicides from human studies and sufficient evidence from animal studies, with positive results on three out of ten key characteristics of carcinogens applying to humans as well. An IARC re-evaluation of the human carcinogenicity of EBDC fungicides is warranted.
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Affiliation(s)
- Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, University of Manchester, Manchester M13 9PL, UK
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5
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Assessment of Hygiene Indicators When Using Gloves by Transport Workers in Russia during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031198. [PMID: 35162223 PMCID: PMC8834553 DOI: 10.3390/ijerph19031198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 12/18/2022]
Abstract
The COVID-19 outbreak represents a global public health emergency. National governments have gradually introduced restrictive measures. Using respiratory protective equipment (face masks) and gloves was essential practice without specific infection control measures or guidelines. This study aimed to assess hygiene indicators when using gloves by transport workers in Russia during the COVID-19 pandemic and to develop integral indicators and recommendations for wearing gloves for workers for whom this is a mandatory requirement. For this purpose, 1103 transport workers were surveyed using a questionnaire. We investigated the hygiene aspects of gloves and evaluated the bacterial contamination of the contact side of the gloves based on the wash results. We assessed the socio-demographic characteristics of the respondents, the duration of the work shift, the frequency of use of types of gloves, skin manifestations, the degree of comfort, and bacterial growth. We carried out the ranking according to comfort, the absence of adverse dermatological reactions when wearing gloves, and bacterial contamination of the inner surface of the gloves. It has been identified that it is necessary to use a comprehensive assessment of gloves to create a register of protective equipment, taking into account the frequency with which it was worn, the severity of the skin condition, comfort, and bacterial contamination.
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Šakić F, Babić Ž, Franić Z, Macan J. Characteristics of hand eczema in final-year apprentice nurses during the COVID-19 pandemic. Contact Dermatitis 2021; 86:98-106. [PMID: 34773266 PMCID: PMC8652632 DOI: 10.1111/cod.14006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Apprentice nurses are considered at high risk to developing occupational skin diseases. OBJECTIVES This study assessed the frequency and origin of hand eczema, and work-related risk factors in apprentice nurses. METHODS The study involved 240 final-year apprentice nurses (females 75%, median age 19 years) from vocational schools in Zagreb, Croatia. The study was performed in 2020/2021 and included a questionnaire and clinical examination by means of the Osnabrück Hand Eczema Severity Index (OHSI). Skin prick test (SPT) with natural rubber latex (NRL) allergen, and patch test with the basic series of allergens, and disinfectants, were performed in 42 apprentice nurses with hand eczema that lasted more than 3 months. RESULTS Clinically observed and self-reported hand eczema were found in 49% and 46% of apprentice nurses, respectively. Those with observed changes were older and reported more days per month spent on practical work than those with healthy skin (P = .001). Median OHSI was 4 (interquartile range 2-6). There were no positive SPTs to latex, and 11 (26%) apprentice nurses had positive patch test reactions to one or more tested allergens, mostly nickel. CONCLUSIONS Hand eczema was common in final-year apprentice nurses during the COVID-19 pandemic. It was mostly of irritative origin, associated with the duration of practical training, confirming cumulative effect of hazards on skin barrier.
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Affiliation(s)
- Franka Šakić
- Unit for Occupational and Environmental Medicine, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Željka Babić
- Unit for Occupational and Environmental Medicine, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Zrinka Franić
- Unit for Occupational and Environmental Medicine, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Jelena Macan
- Unit for Occupational and Environmental Medicine, Institute for Medical Research and Occupational Health, Zagreb, Croatia
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Coppeta L, De Zordo LM, Papa F, Pietroiusti A, Magrini A. Skin sensitization among night shift and daytime healthcare workers: a cross sectional study. Cent Eur J Public Health 2021; 29:191-194. [PMID: 34623118 DOI: 10.21101/cejph.a6260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/15/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Allergic contact dermatitis (ACD) in the healthcare sector is a major occupational health hazard. There are many reasons for a higher frequency of ACD in healthcare personnel compared to other populations: among others, simultaneous exposure to multiple substances, use of aggressive detergents and wet work. However, studies that systematically correlate skin symptoms with the presence of sensitization investigated through patch tests in specific categories of health workers are very rare and conflicting. Although some studies have reported a correlation between skin disease and night shift, the strength of the evidence is rather limited. The purpose of our study was to investigate by means of patch testing the skin sensitization (SS) to common allergens in the hospital setting in a group of healthcare workers (HCW) reporting symptoms related to dermatitis, according to their job activity and their shift status. METHODS 132 HCWs visiting a health surveillance centre were investigated by means of specific questionnaire for dermatitis, followed by patch test evaluation including 40 haptens of the SIDAPA 2016 series. RESULTS Skin sensitization was observed in 1/3 of the subjects investigated by patch tests. The nursing job was strongly associated with cutaneous reactivity after controlling for the confounding of gender, age and other factors. Shift work was related to the prevalence of SS. CONCLUSIONS In our study, the nurse's role and shift work were significantly associated with the risk of cutaneous sensitization, in particular for common antigens.
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Affiliation(s)
- Luca Coppeta
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | | | - Francesca Papa
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | - Antonio Pietroiusti
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Magrini
- Occupational Medicine Department, Tor Vergata University of Rome, Rome, Italy
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8
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control 2021; 49:1305-1315. [PMID: 33965463 PMCID: PMC8102386 DOI: 10.1016/j.ajic.2021.04.084] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have been obliged to wear personal protective equipment (PPE). We assessed the impact of PPE use on HCWs' physical health and we examined factors related to a greater risk of adverse events due to PPE use. METHODS We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and medRxiv from January 1, 2020 to December 27, 2020. RESULTS Our review included 14 studies with 11,746 HCWs. The estimated overall prevalence of adverse events among HCWs was 78% with a range from 42.8% to 95.1% among studies. Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: obesity, diabetes mellitus, smoking, pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. CONCLUSIONS The frequency of adverse events among HCWs due to PPE use is very high. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.
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Affiliation(s)
- Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Despoina Fragkou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Daphne Kaitelidou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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9
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Huang C, Greig D, Cheng H. Allergic contact dermatitis in healthcare workers. Occup Med (Lond) 2021; 71:294-297. [PMID: 34455441 DOI: 10.1093/occmed/kqab118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Allergic contact dermatitis is a common occupational skin disease among healthcare workers (HCWs). AIMS This study describes causes of allergic contact dermatitis in New Zealand HCWs. METHODS All HCWs undergoing patch testing between July 2008 and January 2020 at a public hospital patch test clinic and between June 2019 and January 2020 at a private dermatology clinic were included. Data collected included patient demographics, occupation, results of patch testing and pre- and post-patch test diagnoses. RESULTS Out of 837 patients tested, 67 were HCWs. The mean age of HCWs was 41 years (SD 14) and 58 (87%) were female. The most common occupations were nurses (40%), allied health (22%) and doctors (18%). Forty-six (69%) patients had a background of atopic dermatitis. Hand dermatitis was the most common presentation (49%), followed by facial/neck dermatitis (25%). Thirty-eight (57%) had at least one positive reaction on patch testing, including 19 (28%) with a positive result of current relevance. There were 16 relevant reactions to rubber accelerators, 11 to fragrances, 10 to preservatives and 6 to corticosteroids. The most frequent relevant allergens were methylisothiazolinone/methylchloroisothiazolinone (4%), hydroxyisohexyl 3-cyclohexene carboxaldehyde (4%) and methylisothiazolinone (4%). CONCLUSIONS The most common allergens in HCWs were rubber chemicals, fragrances, preservatives and topical corticosteroids. Important allergens for patch testing HCWs are outlined, in particular, those with hand dermatitis should be tested to a rubber series.
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Affiliation(s)
- C Huang
- Department of Dermatology, Auckland City Hospital, Auckland, New Zealand
| | - D Greig
- Department of Dermatology, North Shore Hospital, Auckland, New Zealand.,Department of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - H Cheng
- Department of Dermatology, Auckland City Hospital, Auckland, New Zealand.,Department of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Özkaya E, Elinç Aslan MS. Occupational allergic contact dermatitis: A 24-year, retrospective cohort study from Turkey. Contact Dermatitis 2021; 85:503-513. [PMID: 34263479 DOI: 10.1111/cod.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limited data exist on occupational allergic contact dermatitis (OACD) in Turkey. OBJECTIVES To investigate the epidemiologic profile of OACD in Turkey. METHODS A retrospective cohort study on 294 patients with OACD among 2801 consecutively patch-tested patients in the Allergy Unit of the Dermatology Department of İstanbul Faculty of Medicine between 1996 and 2019. RESULTS The overall prevalence of OACD was 10.5%, showing a male predominance. OACD was most frequently seen in construction workers (45.2%), followed by hairdressers, metalworkers, health care workers, and miscellaneous. The main relevant allergens were chromium in cement, thiurams in rubber gloves, hairdressing chemicals, resins/glues/plastics, metals, isothiazolinones, and fragrances. Hands were the mainly involved site (95.6%). Airborne eczema was observed in 21.4%. Hand and foot eczema and co-sensitizations to chrome and thiuram and chrome and cobalt were significantly associated with being a construction worker. Sensitizations to isothiazolinones in house painters, ammonium persulfate and p-phenylenediamine in hairdressers, and colophonium increased after 2010. CONCLUSION This was the largest group of data on OACD from Turkey, reflecting the importance of rubber glove allergy in all occupations and the striking increase in ammonium persulfate allergy among hairdressers. Chrome and cobalt were still the main cement allergens in Turkey, where the cement directive is not yet in force.
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Affiliation(s)
- Esen Özkaya
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Meryem Sevinç Elinç Aslan
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.,Department of Dermatology, Saltat Klinik, İstanbul, Turkey
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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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12
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Scheinman PL, Vocanson M, Thyssen JP, Johansen JD, Nixon RL, Dear K, Botto NC, Morot J, Goldminz AM. Contact dermatitis. Nat Rev Dis Primers 2021; 7:38. [PMID: 34045488 DOI: 10.1038/s41572-021-00271-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/04/2023]
Abstract
Contact dermatitis (CD) is among the most common inflammatory dermatological conditions and includes allergic CD, photoallergic CD, irritant CD, photoirritant CD (also called phototoxic CD) and protein CD. Occupational CD can be of any type and is the most prevalent occupational skin disease. Each CD type is characterized by different immunological mechanisms and/or requisite exposures. Clinical manifestations of CD vary widely and multiple subtypes may occur simultaneously. The diagnosis relies on clinical presentation, thorough exposure assessment and evaluation with techniques such as patch testing and skin-prick testing. Management is based on patient education, avoidance strategies of specific substances, and topical treatments; in severe or recalcitrant cases, which can negatively affect the quality of life of patients, systemic medications may be needed.
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Affiliation(s)
- Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Marc Vocanson
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jeanne Duus Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Nixon
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Kate Dear
- Skin Health Institute - Occupational Dermatology Research and Education Centre, Carlton, VIC, Australia
| | - Nina C Botto
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Johanna Morot
- CIRI - Centre International de Recherche en Infectiologie, INSERM, U1111; Univ Lyon; Université Claude Bernard Lyon 1; Ecole Normale Supérieure de Lyon; CNRS, UMR, 5308, Lyon, France
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
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Henning MAS, Jemec GB, Ibler KS. Occupational Skin Disease in Physicians: A Review of the Literature. Ann Work Expo Health 2021; 65:11-25. [PMID: 33009561 DOI: 10.1093/annweh/wxaa091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/29/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Occupational skin disease (OSD) arises from work-related activity. However, there is a paucity of literature on OSD in physicians. The aim of the this review was therefore to examine and summarize what types of symptomatic OSD physicians experience. METHODS We conducted a systematic literature search on Cochrane Library, Embase, and Pubmed. RESULTS Contact dermatitis from formaldehyde and glutaraldehyde were found in 11.5 and 13.5% of cases, respectively. In total 2.4-14.9% had latex allergy. The reported standardized incidence ratio of squamous cell carcinoma and melanoma was up to 2.15 [95% confidence interval (CI) 1.57-1.95] and 3.2 (95% CI 1.38-6.31). Transmission of human papilloma virus (HPV) particles during carbon dioxide laser wart ablation were found in 70% of samples collected from protective gloves and in 52% of samples from vapors. CONCLUSIONS The most frequently reported OSD in physicians is contact dermatitis from allergens in disinfectants and rubber gloves. There is also a risk of cutaneous reactions to latex. The incidence of skin cancer was higher in physicians than in the general population, and the reason for this remains unexplained and potentially biased. There are no reports of transmission of patient HPV to surgeons during wart ablation, possibly because of proper use of protective equipment.
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Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
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14
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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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15
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Aalto-Korte K, Koskela K, Pesonen M. Allergic contact dermatitis and other occupational skin diseases in health care workers in the Finnish Register of Occupational Diseases in 2005-2016. Contact Dermatitis 2020; 84:217-223. [PMID: 33277706 DOI: 10.1111/cod.13753] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health care workers are an important risk group for occupational skin disease (OSD). AIMS To study diagnoses and causes of OSDs in health care workers in the Finnish Register of Occupational Diseases (FROD) in 2005-2016. METHODS We searched the FROD for dermatological cases (a) in health care-related occupations defined by ISCO-08 and (b) in the industrial branch of health care defined by European industry standard classification system (NACE rev. 2). RESULTS Health care workers comprised 19% of all OSD cases in the FROD, and irritant contact dermatitis dominated the diagnoses. Nurses and assistant nurses were the largest occupational groups with incidence rates of 3.3 and 2.7/10 000 person years, respectively. Rubber chemicals were by far the most common causative agents of allergic contact dermatitis (ACD) followed by preservatives, the latter mainly comprising isothiazolinones and formaldehyde. Acrylates were important allergens in dental professions. Metals and coconut fatty acid derivatives were the next largest causative groups for ACD. Drugs caused only 1% of the ACD cases. CONCLUSIONS Workers in different health care occupations do not have a uniform risk for OSD, but they share the risk for ACD due to rubber chemicals and various preservatives.
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Affiliation(s)
- Kristiina Aalto-Korte
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Kirsi Koskela
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Tampere, Finland
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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17
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Patella V, Delfino G, Florio G, Spadaro G, Chieco Bianchi F, Senna G, Di Gioacchino M. Management of the patient with allergic and immunological disorders in the pandemic COVID-19 era. Clin Mol Allergy 2020; 18:18. [PMID: 33020697 PMCID: PMC7528155 DOI: 10.1186/s12948-020-00134-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/12/2020] [Indexed: 01/20/2023] Open
Abstract
The pandemic COVID-19 abruptly exploded, taking most health professionals around the world unprepared. Italy, the first European country to be hit violently, was forced to activate the lockdown in mid-February 2020. At the time of the spread, a high number of victims were quickly registered, especially in the regions of Northern Italy which have a high rate of highly-polluting production activities. The need to hospitalize the large number of patients with severe forms of COVID-19 led the National Health System to move a large number of specialists from their disciplines to the emergency hospital departments for the treatment of COVID-19. Furthermore, the lockdown itself has limited the possibility for general practitioners and pediatricians to be able to make outpatient visits and/or home care for patients with chronic diseases. Among them, the patient with atopic diseases, such as asthma, rhinitis and atopic dermatitis, is worthy of particular attention as she/he is immersed in a studded negative scenario with the onset of spring, a factor that should not be underestimated for those who suffer from pollen allergy. The Italian Society of Asthma Allergology and Clinical Immunology, to quickly deal with the lack of references and specialist medical procedures, has produced a series of indications for immunologic patient care that are reported in this paper, and can be used as guidelines by specialists of our discipline.
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Affiliation(s)
- Vincenzo Patella
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy.,Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Gabriele Delfino
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Giovanni Florio
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Giuseppe Spadaro
- Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.,Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Gianerico Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy.,Chairman of Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Mario Di Gioacchino
- Center of Advanced Science and Technology, G. D'Annunzio University, Chieti-Pescara, Italy.,Leonardo Da Vinci, University, Chieti, Italy
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18
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Lee HC, Goh CL. 'Occupational dermatoses from Personal Protective Equipment during the COVID-19 pandemic in the tropics - A Review'. J Eur Acad Dermatol Venereol 2020; 35:589-596. [PMID: 32894602 DOI: 10.1111/jdv.16925] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic has enveloped the world and there has been a high incidence of occupational dermatoses related to Personal Protective Equipment (PPE) amongst healthcare workers (HCWs) during this period. Prevention and management of these conditions will not only improve staff morale and quality of life, but will also minimize the risk of breaching PPE protocol due to such symptoms. The tropical climate in Singapore predisposes HCWs to more skin damage and pruritus due to intense heat, high humidity and sun exposure. The effects of friction, occlusion, hyperhidrosis and overheating on the skin in the tropics should not be neglected. Preventive measures can be taken based on our recommendations, and the working environment can be made more conducive for frontline HCWs. We review the literature and discuss various preventive and management strategies for these occupational skin diseases for our frontline HCWs, especially those working in less controlled working environments beyond the hospital in Singapore. Shorter shifts and frequent breaks from PPE are recommended. Duration of continuous PPE-usage should not exceed 6 h, with breaks in non-contaminated areas every 2-3 h to hydrate and mitigate the risk of skin reactions. Other strategies, such as teledermatology, should be considered so that consultations can remain accessible, while ensuring the safety and well-being of our clinical staff.
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Affiliation(s)
- H C Lee
- Dermatology Department, KK Women's and Children's Hospital, Singapore
| | - C L Goh
- National Skin Centre, Singapore
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19
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Tan SW, Oh CC. Contact Dermatitis from Hand Hygiene Practices in the COVID-19 Pandemic. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic continues to spread globally at a staggering speed. At present, there is no effective treatment or vaccine for COVID-19. Hand disinfection is a cost-effective way to prevent its transmission. According to the Centres for Disease Control and Prevention (CDC) guidelines, we should wash our hands with soap and water for at least 20 seconds. If soap and water are not readily available, alcohol-based hand rubs (ABHRs) with at least 60% alcohol are the alternative. With diligent hand disinfection reinforced during COVID-19, there is an increased prevalence of contact dermatitis. This commentary highlights the fact that contact dermatitis is a readily treatable condi tion and should not cause any deviation of proper hand hygiene. In irritant contact dermatitis (ICD), the management strategies are selection of less irritating hand hygiene products, frequent use of moisturisers to rebuild the skin barrier, and education on proper hand hygiene practices. In allergic contact dermatitis (ACD), the identification and avoidance of the contact allergen is the key to treatment. However, ACD is less common and only accounts for 20% of the cases. The identified allergens in hand cleansers are predominantly preservative excipients a nd ACD attributable to ABHR are very uncommon. Alcohol-free hand rubs are widely available on the market but it is not a recommended alternative to ABHRs by the CDC.
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20
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Sedó-Mejía G, Soto-Rodríguez A, Pino-García C, Sanabria-Castro A, Monge-Ortega OP. Contact dermatitis: Clinical practice findings from a single tertiary referral hospital, a 4-Year retrospective study. World Allergy Organ J 2020; 13:100440. [PMID: 32817780 PMCID: PMC7426576 DOI: 10.1016/j.waojou.2020.100440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is estimated that 20% of the general population is sensitized to some kind of contact allergen. Contact dermatitis is one of the major occupational diseases worldwide. This disease has a higher prevalence in the female gender and is more frequently observed in the third or fourth decade of life. The main objective of this study was to describe the main sociodemographic and clinical characteristics of patients with contact dermatitis treated in the Allergy Unit of the San Juan De Dios Hospital - Caja Costarricense de Seguro Social. METHODS Clinical records of contact dermatitis outpatients from a single hospital were analyzed, in a 4-year retrospective observational study. RESULTS At the time of the patch testing, patients showed a mean age of 42.2 years. Disease frequency was higher in the female population (female/male ratio of 4.2:1) and in patients mostly dedicated to household workchores. Most patients presented several years of disease history, and the hands were the highest affected body part. Patch testing revealed that nickel sulfate, Cl+Me-Isothiazolinone (Kathon CG), and thimerosal were allergens regularly associated with contact dermatitis in the analyzed population. CONCLUSIONS To a great extent, sociodemographic and clinical characteristics identified in these patients resemble what is reported in other regions, including the Americas and worldwide. It is worth highlighting a high female proportion rate probably related to cultural aspects, a smaller percentage of irritant contact dermatitis that may be associated to institutional patient management, and a slight difference in the most common allergens when compared to other published studies.
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Affiliation(s)
- Giovanni Sedó-Mejía
- Allergy Unit, Hospital San Juan de Dios – Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Andrés Soto-Rodríguez
- Research Unit, Hospital San Juan de Dios – Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Caridad Pino-García
- Allergy Unit, Hospital San Juan de Dios – Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Alfredo Sanabria-Castro
- Research Unit, Hospital San Juan de Dios – Caja Costarricense de Seguro Social, San José, Costa Rica
- Faculty of Pharmacy, Universidad de Costa Rica
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21
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França D, Sacadura-Leite E, Fernandes-Almeida C, Filipe P. Occupational dermatoses among healthcare workers in a hospital center in Portugal. Rev Bras Med Trab 2020; 17:285-291. [PMID: 32368662 PMCID: PMC7195876 DOI: 10.5327/z1679443520190393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. OBJECTIVE To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. METHODS Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. RESULTS About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). CONCLUSION The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.
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Affiliation(s)
- Diana França
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | - Ema Sacadura-Leite
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | | | - Paulo Filipe
- Dermatology Department, North Lisbon Hospital Center – Lisbon, Portugal
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22
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Sessink PJM, Nyulasi T, Haraldsson ELM, Rebic B. Reduction of Contamination with Antibiotics on Surfaces and in Environmental Air in Three European Hospitals Following Implementation of a Closed-System Drug Transfer Device. Ann Work Expo Health 2020; 63:459-467. [PMID: 30852616 DOI: 10.1093/annweh/wxz010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 01/07/2019] [Accepted: 01/29/2019] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Occupational exposure of nurses to antibiotics may result in adverse health effects such as hypersensitivity, allergic reactions, resistance, and anaphylactic shock. The purpose of this study was to measure surface and air contamination with antibiotics in three hospitals during the preparation of the drugs using conventional techniques or using the Tevadaptor® closed-system drug transfer device (CSTD). METHODS Surface contamination was measured by taking wipe samples. Stationary air samples were collected in preparation areas and personal air samples were collected in the working environment of the nurses. Contamination was reassessed after several weeks following implementation of the CSTD. Surface contamination was compared before and after CSTD introduction. Vancomycin, meronem, augmentin, ceftriaxone, cefotaxime, piperacillin, and benzylpenicillin were monitored. Wipe and air samples were analyzed using liquid chromatographytandem mass spectrometry (LC-MS/MS). RESULTS Using conventional preparation techniques, widespread contamination with antibiotics up to 767 ng cm-2 was detected. After implementation of the CSTD, contamination levels significantly decreased for the most frequently prepared antibiotics in the three hospitals.Using the conventional preparation technique, three antibiotics were detected in environmental air of seven nurses in two hospitals (0.01-5 µg m-3), and one antibiotic was found in environmental air above a preparation surface (0.02 µg m-3). After implementation of the CSTD, the same antibiotic was detected in environmental air above the same preparation surface (1.39 µg m-3) but no antibiotics were detected in environmental air of the nurses in the three hospitals. CONCLUSIONS Using the conventional preparation techniques, surfaces and air were widely contaminated with antibiotics whereas the use of the CSTD significantly reduced contamination. Systematic use of a CSTD significantly reduces exposure to hazardous antibiotics and consequently reduces potential adverse health effects for healthcare providers.
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Affiliation(s)
| | - Tibor Nyulasi
- Intensive Care Department, Szent János Hospital, Budapest, Hungary
| | | | - Branislava Rebic
- Pharmacy Department, University Children's Hospital, Belgrade, Serbia
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23
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Abstract
OBJECTIVE To determine the frequency of self-reported hand dermatitis and the factors influencing its prevalence among nursing students. METHODS Researchers collected demographic data and used a self-assessment form to identify dermatologic symptoms. The questionnaires were distributed to the students and collected again after the students completed the forms. RESULTS Hand dermatitis was present in 20.9% of nursing students. The most common symptoms were irritation/pruritus, redness/cracking, flaking/rash, swelling, and vesicles in hands. The grade of the student, the presence of allergy complaints, and medication used to treat dermatitis were statistically significantly associated with dermatitis prevalence. The use of gloves and cleansing agents used in handwashing were factors linked to hand dermatitis. CONCLUSIONS Hand dermatitis increases in parallel with the increase of clinical practice hours among nursing students. Familial and environmental factors also increase the risk of hand dermatitis.
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24
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Irritant Contact Dermatitis: Why It Happens, Who Suffers It and How to Manage. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_61-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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An uncommon outbreak of irritant contact dermatitis caused by rubber accelerators: a historical cohort study. J RUBBER RES 2019. [DOI: 10.1007/s42464-019-00023-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Alhaji MM, Lai A, Naing L, Tuah NA. Self-Reported Skin Disorders Among Health Care Workers. Workplace Health Saf 2019; 67:294-301. [DOI: 10.1177/2165079918795958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to estimate the point prevalence and 1-year period prevalence of skin disorder symptoms (SDS) among health care workers (HCWs) and to explore the possible risk factors. A random sample of 400 HCWs from 13 government health centers in Brunei Darussalam self-administered an adapted Nordic Occupational Skin Questionnaire (NOSQ-2002/SHORT). The point and 1-year prevalence of SDS were 12% and 19%, respectively. Having a history of SDS before the current job, exposure to SDS-exacerbating materials at the workplace, and having clinical roles were correlated for both prevalence estimates. Frequent handwashing and moderate use of latex gloves were associated with higher risk of SDS at 1-year. Female HCWs were more likely to report SDS. In multivariate analyses, only contact with SDS-exacerbating materials at the workplace, prejob SDS, and moderate glove usage were significant predictors of SDS.
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Affiliation(s)
| | - Alice Lai
- Universiti Brunei Darussalam
- Ministry of Health, Brunei Darussalam
| | | | - Nik Ani Tuah
- Universiti Brunei Darussalam
- Imperial College London
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28
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de Groot AC. Myroxylon pereirae
resin (balsam of Peru) – A critical review of the literature and assessment of the significance of positive patch test reactions and the usefulness of restrictive diets. Contact Dermatitis 2019; 80:335-353. [DOI: 10.1111/cod.13263] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
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29
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Hamnerius N, Pontén A, Björk J, Persson C, Bergendorff O. Skin exposure to the rubber accelerator diphenylguanidine in medical gloves-An experimental study. Contact Dermatitis 2019; 81:9-16. [PMID: 30724364 DOI: 10.1111/cod.13238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/01/2019] [Accepted: 02/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dermatitis caused by occupational contact allergy to rubber additives such as diphenylguanidine (DPG) in medical gloves is a hazard for healthcare workers. Both the duration of exposure to medical gloves and the number of gloves used per day vary. The use of alcoholic skin disinfectants before glove donning is mandatory. OBJECTIVES To assess whether skin exposure to the rubber accelerator DPG released from glove material is influenced by alcoholic hand disinfectants, time, and pH. METHODS With the use of ethanol washes, the amount of DPG left on the hands after wearing of gloves for 60 minutes was measured, and comparisons between hands exposed and not exposed to alcoholic disinfectant before glove donning were made. With the use of artificial sweat buffered at pH 4, 5, and 6, DPG release from the insides of gloves at different times was measured. RESULTS The use of alcoholic disinfectant prior to polyisoprene glove donning increased the amount of DPG recovered from the hands. Of the DPG released from polyisoprene gloves into artificial sweat, almost 84% was released within 10 minutes. pH did not influence the rate of release. CONCLUSIONS The use of alcoholic disinfectant increased skin exposure to the rubber accelerator DPG. Even a short duration of use of gloves results in substantial exposure to DPG.
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Affiliation(s)
- Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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30
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Occupational Contact Dermatitis: Health Personnel. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_43-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_61-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Archibong J, Henshaw E, Ogunbiyi A, George A. Occupational skin disorders in a subset of Nigerian hairdressers. Pan Afr Med J 2018; 31:100. [PMID: 31011400 PMCID: PMC6461971 DOI: 10.11604/pamj.2018.31.100.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 09/30/2018] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Hairdressing is associated with a wide range of disorders. This is particularly true in the African hairdresser, who is saddled with the responsibility of 'taming' the rather difficult-to-manage African hair, and is thus exposed to a wide range of chemical, biological and physical materials in the hair grooming process. We therefore sought to determine the prevalence and pattern of occupational skin disorders among hairdressers in Ibadan, one of the oldest and largest cities in Nigeria. METHODS This was a cross sectional study of hairdressers conducted in 2013 in Ibadan, Nigeria. Hairdressers and their apprentices were interviewed using a structured questionnaire, following which a thorough physical examination was performed to identify any skin disorder. RESULTS A total of 226 hairstylists were recruited. The prevalence of occupational skin disorders in the study was 68.13%. The prevalence of specific skin disorders was 32.74% for nail disorders; 28.75% for traumatic skin disorders; and 2.64% for hand dermatitis. CONCLUSION There is a high prevalence of occupational skin disorders among hairdressers, and this may have personal and public health implications.
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Affiliation(s)
- Joseph Archibong
- Dermatology Unit, Department of Internal Medicine, University of Calabar, Nigeria
| | - Eshan Henshaw
- Dermatology Unit, Department of Internal Medicine, University of Calabar, Nigeria
| | - Adebola Ogunbiyi
- Department of Medicine, University College Hospital Ibadan, Nigeria
| | - Adekunle George
- Department of Medicine, University College Hospital Ibadan, Nigeria
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Hamnerius N, Svedman C, Bergendorff O, Björk J, Bruze M, Engfeldt M, Pontén A. Hand eczema and occupational contact allergies in healthcare workers with a focus on rubber additives. Contact Dermatitis 2018; 79:149-156. [PMID: 29923205 DOI: 10.1111/cod.13042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. OBJECTIVES To assess HE and contact allergy related to occupational exposures in HCWs. METHODS In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. RESULTS Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. CONCLUSION Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated.
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Affiliation(s)
- Nils Hamnerius
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jonas Björk
- Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Malin Engfeldt
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ann Pontén
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Carey RN, Fritschi L, Driscoll TR, Abramson MJ, Glass DC, Darcey E, Si S, Benke G, Reid A, El-Zaemey S. Latex glove use among healthcare workers in Australia. Am J Infect Control 2018; 46:1014-1018. [PMID: 29678453 DOI: 10.1016/j.ajic.2018.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Exposure to natural rubber latex, primarily through the use of gloves, is a well-recognized cause of occupational asthma. We investigated latex glove use among Australian workers and estimated the resultant burden of occupational asthma among healthcare workers (HCWs). METHODS Data were collected in 2014 as part of the Australian Work Exposures Study-Asthma, a telephone survey investigating the prevalence of current occupational exposure to asthmagens, including latex. We estimated adjusted prevalence ratios (aPRs) to determine variables associated with the use of latex gloves among HCWs and calculated the asthma-related disability-adjusted life years due to latex exposure among HCWs. RESULTS Latex gloves were used by 22% of respondents. Almost two-thirds (63%) of HCWs reported wearing latex gloves, with 26% using powdered latex gloves. The use of latex gloves was more common among those employed in micro companies (less than 5 employees) than large companies (200+ employees) (aPR = 1.5, 95% confidence interval 1.1-2.0). Latex exposure in HCWs was estimated to contribute 3% of the total asthma-related burden. DISCUSSION Latex gloves are widely used by Australian workers and by HCWs in particular. CONCLUSIONS This is the first estimate of the burden of asthma attributable to occupational exposure to latex among HCWs. These results can be used to guide decisions regarding the control of occupational exposure to latex.
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Affiliation(s)
- Renee N Carey
- School of Public Health, Curtin University, Bentley, Western Australia, Australia.
| | - Lin Fritschi
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Timothy R Driscoll
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Deborah C Glass
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ellie Darcey
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Si Si
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Sonia El-Zaemey
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
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Uter W, Bauer A, Bensefa-Colas L, Brans R, Crépy MN, Giménez-Arnau A, Larese Filon F, Ljubojević Hadžavdić S, Pesonen M, Schuttelaar ML, Wilkinson M, Lidén C. Extended documentation for hand dermatitis patients: Pilot study on irritant exposures. Contact Dermatitis 2018; 79:168-174. [DOI: 10.1111/cod.13035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/18/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; Erlangen Germany
| | - Andrea Bauer
- Department of Dermatology; University Hospital Carl Gustav Carus, University Allergy Centre, Technical University of Dresden; Dresden Germany
| | - Lynda Bensefa-Colas
- Occupational and Environmental Diseases Department; University Hospital of Centre of Paris, Hôtel-Dieu Hospital, AP-HP; Paris France
- Laboratoire Santé Publique et Environnement, EA 4064; Descartes University, Sorbonne Paris Cité; Paris France
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
| | - Marie-Noëlle Crépy
- Occupational and Environmental Diseases Department; University Hospital of Centre of Paris, Hôtel-Dieu Hospital, AP-HP; Paris France
| | - Ana Giménez-Arnau
- Department of Dermatology; Hospital del Mar, Institut Mar d'Investigacions Mediques, Universitat Autónoma; Barcelona Spain
| | - Francesca Larese Filon
- Department of Medical Sciences; Unit of Occupational Medicine, University of Trieste; Trieste Italy
| | | | - Maria Pesonen
- Occupational Medicine; Finnish Institute of Occupational Health (FIOH), Työterveyslaitos; Helsinki Finland
| | - Marie L. Schuttelaar
- Department of Dermatology; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Mark Wilkinson
- Department of Dermatology; Chapel Allerton Hospital; Leeds UK
| | - Carola Lidén
- Department of Environmental Medicine, Karolinska Institutet; Stockholm Sweden
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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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Gupta SB, Gupta A, Shah B, Kothari P, Darall S, Boghara D, Sonkar S, Deo K. Hand eczema in nurses, nursing auxiliaries and cleaners-A cross-sectional study from a tertiary hospital in western India. Contact Dermatitis 2018; 79:20-25. [PMID: 29691869 DOI: 10.1111/cod.13009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/09/2018] [Accepted: 03/11/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Healthcare workers have a high risk of developing hand eczema. OBJECTIVES To determine the prevalence and severity of dermatologist-determined hand eczema among healthcare workers, carry out patch testing, and correlate the findings with impairment in quality of life (QoL) and demographic and vocational factors. METHODS Seven hundred and ten healthcare workers (279 nurses, 246 cleaners, and 185 nursing auxiliaries) were screened for the presence of hand eczema. Severity of eczema was calculated with the Hand Eczema Severity Index (HECSI), and QoL was measured with the Dermatology Life Quality Index (DLQI). Individuals with hand eczema were also patch tested. RESULTS The point and 1-year prevalences of hand eczema were 7.2% and 18.9%, respectively. Hand eczema was significantly associated with atopic dermatitis. The mean HECSI score was 9.39; it was significantly higher in patients with atopic dermatitis and those with recurrent hand eczema. The mean DLQI score was 5.37. Cleaning staff had significantly greater impairment in QoL. HECSI and DLQI scores were positively correlated. Patch testing showed that thiuram mix, antibiotics and cleansers as sensitizers were over-represented in healthcare workers as compared with controls. CONCLUSIONS Hand eczema was particularly common in hospital cleaners and staff with atopic dermatitis. Further studies are needed to address the burden of occupational hand eczema and develop guidelines for its management at a national level.
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Affiliation(s)
- Sanjeev B Gupta
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Aayush Gupta
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Bhavika Shah
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Preeti Kothari
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Sweety Darall
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Dhara Boghara
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Sukhnandan Sonkar
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
| | - Kirti Deo
- Dr D. Y. Patil Medical College-Dermatology, Venereology and Leprosy, Pune, India
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Keegel T, Nixon RL. Wet work and healthcare workers: use of hand disinfectants not associated with self-reported eczema. Br J Dermatol 2018; 178:324-325. [PMID: 29441539 DOI: 10.1111/bjd.16166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- T Keegel
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Monash Centre for Occupational and Environmental Health, Melbourne, Australia
| | - R L Nixon
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Carlton, Australia.,Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
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40
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Pinheiro V, Pestana C, Pinho A, Antunes I, Gonçalo M. Occupational allergic contact dermatitis caused by antibiotics in healthcare workers - relationship with non-immediate drug eruptions. Contact Dermatitis 2018; 78:281-286. [DOI: 10.1111/cod.12960] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Vítor Pinheiro
- Occupational Health Department; Coimbra Hospital and University Centre (CHUC); Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
| | - Catarina Pestana
- Occupational Health Department; Coimbra Hospital and University Centre (CHUC); Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
| | - André Pinho
- Dermatology Department; Coimbra Hospital and University Centre (CHUC); Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
| | - Isabel Antunes
- Occupational Health Department; Coimbra Hospital and University Centre (CHUC); Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
| | - Margarida Gonçalo
- Dermatology Department; Coimbra Hospital and University Centre (CHUC); Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
- Dermatology Clinic, Medicine Faculty; Coimbra University; Praceta Prof. Mota Pinto, 3000-075 Coimbra Portugal
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Hamnerius N, Svedman C, Bergendorff O, Björk J, Bruze M, Pontén A. Wet work exposure and hand eczema among healthcare workers: a cross-sectional study. Br J Dermatol 2017; 178:452-461. [DOI: 10.1111/bjd.15813] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 01/20/2023]
Affiliation(s)
- N. Hamnerius
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - C. Svedman
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - O. Bergendorff
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - J. Björk
- Department of Occupational and Environmental Medicine; Lund University; Lund Sweden
- Clinical Studies Sweden; Forum South; Skåne University Hospital; Lund Sweden
| | - M. Bruze
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - A. Pontén
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
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Mai W, Liu X, Su G, Zhou W, Wen Z, Lu D. Elevation of Circulating Th17/Th22 Cells Exposed to Low-Level Formaldehyde and Its Relevance to Formaldehyde-Induced Occupational Allergic Contact Dermatitis. J Occup Environ Med 2017; 59:817-821. [PMID: 28697061 DOI: 10.1097/jom.0000000000001074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of formaldehyde exposure on Th17 and Th22 cells and its relevance to human occupational allergic contact dermatitis (OACD). METHODS Circulating IL17-/IL22-secreting cells and serum IL17/IL22 levels in formaldehyde-exposed workers at Occupational Exposure Limit and nonexposed controls were assessed. RESULTS The IL17 and IL22 cell population were detected in both CD3CD8 and CD3CD8 cells. The percentages of circulating IL17 and IL22 T cells in the workers with and without ACD history were all elevated, which were more remarkable in the ones with ACD history. Serum levels of IL17 and IL22 between the workers and controls were not significantly different. CONCLUSIONS Low-level formaldehyde exposure may increase circulating IL17-/IL22-producing T cells (CD8 and CD8), possibly involved in the development of human OACD. But it may not alter serum levels of IL17/IL22 before the appearance of OACD symptoms.
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Affiliation(s)
- Weihua Mai
- Department of Prevention and Healthcare, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China (Dr Mai, Su); Department of General Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China (Mr Liu); Department of Laboratory Science, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China (Ms Zhou); and Department of Dermatology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China (Mr Wen, Mr Lu)
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Helaskoski E, Suojalehto H, Kuuliala O, Aalto-Korte K. Occupational contact urticaria and protein contact dermatitis: causes and concomitant airway diseases. Contact Dermatitis 2017; 77:390-396. [PMID: 28795430 DOI: 10.1111/cod.12856] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Contact urticaria (CU) and protein contact dermatitis (PCD) are mainly induced by an immediate, IgE-mediated immunological mechanism. Immediate sensitization is also linked to asthma and/or allergic rhinitis. OBJECTIVES To report causes of work-induced CU and PCD, and to evaluate the occurrence of concomitant airway diseases. METHODS We retrospectively reviewed the patient files of cases diagnosed with CU or PCD at the Finnish Institute of Occupational Health during 1995-2011. We obtained data on occupation, exposures, clinical and immunological test results, and diagnosed occupational skin and respiratory diseases. RESULTS Altogether, 291 cases of occupational CU or PCD were diagnosed during the study period. The most common causes were flour, cow dander, natural rubber latex and acid anhydrides. Concomitant occupational asthma caused by the same agent as the skin disease was detected in 60 patients (21%), and occupational rhinitis was detected in 111 patients (38%). CONCLUSIONS Almost half of the patients (46%) with occupational CU and PCD had concomitant occupational airway disease. Patients with CU/PCD should always be asked about respiratory symptoms, and preventive measures at the workplace should include protection of both the skin and the airways.
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Affiliation(s)
- Eva Helaskoski
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland.,Department of Public Health, University of Helsinki, 00014, Helsinki, Finland
| | - Hille Suojalehto
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
| | - Outi Kuuliala
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
| | - Kristiina Aalto-Korte
- Occupational Medicine, Finnish Institute of Occupational Health, 00251, Helsinki, Finland
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