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Aalto-Korte K, Pesonen M, Suomela S, Suuronen K. Nine years of patch testing with isocyanates in a clinic of occupational dermatology. Contact Dermatitis 2024; 91:212-221. [PMID: 38956835 DOI: 10.1111/cod.14621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Isocyanates are used as starting materials of polyurethane (PU) products. They are relatively important occupational skin sensitizers. OBJECTIVES To analyse results of a large isocyanate patch test series of 19 isocyanate test substances and 4,4'-diaminodiphenylmethane (MDA), a marker of 4,4'-diphenylmethane diisocyanate (MDI) hypersensitivity. METHODS Test files were screened for positive reactions in the isocyanate series. Patients with positive reactions were analysed for occupation, exposure and diagnosis. RESULTS In 2010-2019, 53 patients had positive reactions in the series (16% of 338 patients tested). MDA, the well-established screening substance for MDI allergy, was positive in 30 patients, an in-house monomeric MDI test substance in 23 patients and 3 different polymeric MDI test substances in 19-21 patients. We diagnosed 16 cases of occupational allergic contact dermatitis (OACD) from MDI including 3 pipe reliners. Hexamethylene-1,6-diisocyanate (HDI) oligomers in paint hardeners caused 5 cases of OACD, more cases than 2,4-toluene diisocyanate (TDI; n = 3) and isophorone diisocyanate (IPDI; n = 1) put together. CONCLUSIONS In contrast to previous studies, polymeric MDI test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised not only by epoxy products and acrylates but also by MDI in hardeners of PU pipe coatings. HDI oligomers were the second most important causes of OACD after MDI.
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Affiliation(s)
- Kristiina Aalto-Korte
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Maria Pesonen
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Sari Suomela
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Katri Suuronen
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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Rydz E, Walld R, Quinn EK, Koehoorn MW, McLeod CB, Demers PA, Peters CE, Kraut A. Assessing contact dermatitis risk among Manitoba workers in the Manitoba Occupational Disease Surveillance System. Contact Dermatitis 2024. [PMID: 39138617 DOI: 10.1111/cod.14674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION This exploratory study aimed to assess contact dermatitis (CD) risk among workers using the Manitoba Occupational Disease Surveillance System (MODSS). METHODS The MODSS linked accepted time-loss claims from the Workers' Compensation Board of Manitoba (2006-2019), with administrative health data from medical and hospital records (1996-2020). CD risk by occupation and industry (hazard ratio, 95% confidence intervals) was estimated using Cox proportional hazard models, adjusted for age and stratified by sex. RESULTS Increased risk of new onset CD was observed among some occupations and industries with known skin irritants and allergens. Some occupations with known increased risks of CD remained elevated when removing the accepted WCB cases was performed, suggesting that all CD cases in these occupations may not show up in WCB statistics. Increased risk was also observed for occupations and industries with unknown exposures related to CD, whereas some groups known to be at risk of CD were not observed to have elevated risks in this cohort. DISCUSSION The MODSS successfully identified some occupations and industries known to be at high risk of occupational CD, but not others. Some occupations not typically associated with work-related CD were also identified, which warrants further investigation.
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Affiliation(s)
- E Rydz
- CAREX Canada, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - R Walld
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - E K Quinn
- CAREX Canada, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M W Koehoorn
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - C B McLeod
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - P A Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - C E Peters
- CAREX Canada, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- BC Cancer, Vancouver, British Columbia, Canada
| | - A Kraut
- Department of Internal Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Karagounis TK, Cohen DE. Occupational Hand Dermatitis. Curr Allergy Asthma Rep 2023; 23:201-212. [PMID: 36749448 PMCID: PMC9903276 DOI: 10.1007/s11882-023-01070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers' quality of life and for occupation-specific retention. RECENT FINDINGS This is a critical review of the current literature on occupational hand dermatitis. Occupational dermatitis continues to have a high prevalence among workers although the overall incidence may be slowly decreasing. Irritant contact dermatitis due to wet work exposure is the most common cause of occupational hand dermatitis. Healthcare workers, hairdressers, and metal workers are at particularly high risk for this disease. While some prevention programs have been ineffective in mitigating occupational hand dermatitis, other more resource-intensive initiatives may have benefit. Continued research is needed on ways to manage wet work exposures and on scalable, effective prevention programs for occupational hand dermatitis. The spectrum of culprit contact allergens continues to evolve, and vigilance for potential occupation-specific allergens remains important.
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Affiliation(s)
- Theodora K. Karagounis
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY USA
| | - David E. Cohen
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY USA
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Suomela S, Pesonen M, Ylinen K, Aalto-Korte K, Suuronen K. Characterization of patients with occupational allergy to two new epoxy hardener compounds. Contact Dermatitis 2022; 87:81-88. [PMID: 35293005 PMCID: PMC9321617 DOI: 10.1111/cod.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
Background The practical importance of two recently described epoxy hardener allergens—1,3‐benzenedimethanamine, N‐(2‐phenylethyl) derivatives (1,3‐BDMA‐D) and hydrogenated formaldehyde benzenamine polymer (FBAP)—as occupational allergens remains to be defined. Objectives To describe patients diagnosed at the Finnish Institute of Occupational Health (FIOH) with positive reactions to 1,3‐BDMA‐D or FBAP. Methods We searched FIOH's patch‐test files from January 2017 to December 2020 for patients examined due to suspected occupational contact allergy to epoxy compounds. We analyzed the patch‐test results and sources of exposure to various epoxy hardeners and focused on occupations, symptoms, and the sources of exposure to 1,3‐BDMA‐D and FBAP. Results During the study period, 102 patients were examined at FIOH for suspected occupational contact allergy to epoxy compounds. Of these, 19 (19%) were diagnosed with contact allergy to 1,3‐BDMA‐D (n = 10) or FBAP (n = 12). The largest occupational group was sewage pipe reliners (n = 8). Seven different hardener products contained FBAP, whereas 1,3‐BDMA‐D was present in only one hardener used by spray painters. Conclusions A substantial number of patients with suspected occupational epoxy resin system allergy tested positive to in‐house test substances of 1,3‐BDMA‐D and/or FBAP.
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Affiliation(s)
- Sari Suomela
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Maria Pesonen
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Katriina Ylinen
- Work Environment Laboratories, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Kristiina Aalto-Korte
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Katri Suuronen
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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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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Aalto-Korte K, Pesonen M. Patterns of positive patch test reactions to formaldehyde and formaldehyde releasers at the Finnish Institute of Occupational Health from 2007 to 2020. Contact Dermatitis 2021; 85:429-434. [PMID: 33934369 DOI: 10.1111/cod.13876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Formaldehyde is an important contact sensitizer. Formaldehyde releasing substances induce positive reactions in formaldehyde-allergic patients, but there are also reactions independent of formaldehyde allergy. In an earlier study, stronger formaldehyde reactions led to more positive reactions to quaternium-15. OBJECTIVES To analyze patterns of positive patch test reactions to formaldehyde and different formaldehyde releasers. METHODS Patch test files of 1497 patients investigated during the period November 2007-August 2020 were retrospectively reviewed for positive reactions to formaldehyde and its releasers. During the study period, almost all (≥99.3%) patients were tested with a formaldehyde dilution series and six formaldehyde releasers. RESULTS Ninety-three patients tested positive to formaldehyde; 80% of these had positive reactions to at least one formaldehyde releaser, most often benzylhemiformal. There were only nine independent contact allergies to formaldehyde releasers. There were only two reactions to 2-bromo-2-nitropropane-1,3-diol and they occurred in formaldehyde-negative patients. In patients with extreme (+++) reactions to formaldehyde, concomitant positive reactions to any of the other 11 investigated formaldehyde releasers were more common than in patients with milder formaldehyde reactions. CONCLUSIONS Strong formaldehyde reactions were associated with positive reactions to formaldehyde releasers.
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Affiliation(s)
- Kristiina Aalto-Korte
- Finnish Institute of Occupational Health (FIOH), Occupational Health Unit, Helsinki, Finland
| | - Maria Pesonen
- Finnish Institute of Occupational Health (FIOH), Occupational Health Unit, Helsinki, Finland
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DeKoven JG, DeKoven BM, Warshaw EM, Mathias CGT, Taylor JS, Sasseville D, Belsito DV, Fowler JF, Pratt MD, Zug KA, Maibach HI, DeLeo VA, Silverberg JI, Atwater AR, Reeder MJ, Holness DL. Occupational contact dermatitis: Retrospective analysis of North American Contact Dermatitis Group Data, 2001 to 2016. J Am Acad Dermatol 2021; 86:782-790. [PMID: 33753252 DOI: 10.1016/j.jaad.2021.03.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patch testing is an important diagnostic tool for suspected allergic contact dermatitis (ACD) in occupational settings. OBJECTIVE Provide an overview of occupational skin disease (OSD) and an analysis of occupational ACD in North American patients undergoing patch testing between 2001and 2016. METHODS Patients with OSD were analyzed for frequency of allergic reactions to a screening series of allergens, occupational relevance, location of skin disease, and exposure sources. Demographic, occupation, and industry information were recorded. RESULTS Of 38,614 patients evaluated, 4471 (11.6%) had OSD, of whom 3150 (70.5%) had ACD. The most common occupationally related allergens included rubber accelerators, preservatives, and bisphenol A epoxy resin. Hands (75.8%), arms (30.0%), and face (15.9%) were common sites of dermatitis. The occupations most affected were service workers and machine operators. LIMITATIONS Our cohort may not reflect the general working population. CONCLUSION This study identified common occupational allergens, exposure sources, and occupations/industries at risk. This information may help the clinician evaluate and manage patients with occupational contact dermatitis.
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Affiliation(s)
- Joel G DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada.
| | - Benjamin M DeKoven
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
| | - Erin M Warshaw
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | | | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical School, New York, New York
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - D Linn Holness
- Division of Occupational Medicine, Department of Medicine, St Michael's Hospital, Unity Health, University of Toronto, Toronto, Ontario, Canada
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Loman L, Uter W, Armario‐Hita JC, Ayala F, Balato A, Ballmer‐Weber BK, Bauer A, Bircher AJ, Buhl T, Czarnecka‐Operacz M, Dickel H, Fuchs T, Giménez Arnau A, John SM, Kränke B, Kręcisz B, Mahler V, Rustemeyer T, Sadowska‐Przytocka A, Sánchez‐Pérez J, Scherer Hofmeier K, Schliemann S, Simon D, Spiewak R, Spring P, Valiukevičienė S, Wagner N, Weisshaar E, Pesonen M, Schuttelaar MLA. European Surveillance System on Contact Allergies (ESSCA): Characteristics of patients patch tested and diagnosed with irritant contact dermatitis. Contact Dermatitis 2021; 85:186-197. [PMID: 33729576 PMCID: PMC8360089 DOI: 10.1111/cod.13833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Irritant contact dermatitis (ICD) is caused by the acute locally toxic effect of a strong irritant, or the cumulative exposure to various weaker physical and/or chemical irritants. OBJECTIVES To describe the characteristics of patients with ICD in the population patch tested in the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) database. METHODS Data collected by the ESSCA in consecutively patch-tested patients from January 2009 to December 2018 were analyzed. RESULTS Of the 68 072 patients, 8702 were diagnosed with ICD (without concomitant allergic contact dermatitis [ACD]). Hand and face were the most reported anatomical sites, and 45.7% of the ICD was occupational ICD (OICD). The highest proportions of OICD were found in metal turners, bakers, pastry cooks, and confectionery makers. Among patients diagnosed with ICD, 45% were found sensitized with no relevance for the current disease. CONCLUSIONS The hands were mainly involved in OICD also in the subgroup of patients with contact dermatitis, in whom relevant contact sensitization had been ruled out, emphasizing the need for limiting irritant exposures. However, in difficult-to-treat contact dermatitis, unrecognized contact allergy, or unrecognized clinical relevance of identified allergies owing to incomplete or wrong product ingredient information must always be considered.
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Affiliation(s)
- Laura Loman
- Department of DermatologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and EpidemiologyFriedrich‐Alexander‐University Erlangen/NürnbergErlangenGermany
| | - José C. Armario‐Hita
- Department of DermatologyUniversity Hospital of Puerto Real, University of CádizCádizSpain
| | - Fabio Ayala
- Department of DermatologyUniversity of Naples Federico IINaplesItaly
| | - Anna Balato
- Department of Advanced Biomedical SciencesUniversity of Naples Federico IINaplesItaly
| | - Barbara K. Ballmer‐Weber
- Department of DermatologyUniversity Hospital ZürichZürichSwitzerland
- Department of DermatologyUniversity Hospital Zürich and Clinic of Dermatology and Allergology, Kantonsspital St GallenZürichSwitzerland
| | - Andrea Bauer
- Department of DermatologyUniversity Hospital Carl Gustav Carus, Technical University of DresdenDresdenGermany
| | - Andreas J. Bircher
- Department of DermatologyAllergy Unit, University Hospital BaselBaselSwitzerland
| | - Timo Buhl
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center GöttingenGöttingenGermany
| | | | - Heinrich Dickel
- Department of Dermatology, Venereology and AllergologyRuhr University BochumBochumGermany
| | - Thomas Fuchs
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center GöttingenGöttingenGermany
| | - Ana Giménez Arnau
- Department of DermatologyHospital del Mar, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Swen M. John
- Department of Dermatology and Environmental MedicineInstitute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Lower Saxony Institute for Occupational Dermatology (NIB)OsnabrückGermany
| | - Birger Kränke
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Beata Kręcisz
- Faculty of Medicine and Health ScienceInstitute of Medical Science, Jan Kochanowski UniversityKielcePoland
- Department of DermatologyNofer Institute of Occupational MedicineŁódźPoland
| | - Vera Mahler
- Department of DermatologyUniversity Hospital of Erlangen, University of Erlangen‐Nuremberg (FAU)ErlangenGermany
- Division of AllergologyPaul‐Ehrlich‐InstitutLangenGermany
| | - Thomas Rustemeyer
- Department of Dermatology‐Allergology and Occupational DermatologyAmsterdam University Medical CentersAmsterdamThe Netherlands
| | | | | | | | - Sibylle Schliemann
- Department of Dermatology and AllergologyUniversity Hospital JenaJenaGermany
| | - Dagmar Simon
- Department of DermatologyInselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Faculty of PharmacyJagiellonian University Medical CollegeKrakowPoland
| | - Philip Spring
- Dermatologie et vénéréologie FMH, Center Médical d'EpalingesEpalingesSwitzerland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal DiseasesLithuanian University of Health SciencesKaunasLithuania
| | - Nicola Wagner
- Department of DermatologyUniversity Hospital of Erlangen, University of Erlangen‐Nuremberg (FAU)ErlangenGermany
| | - Elke Weisshaar
- Department of Dermatology, Occupational DermatologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Maria Pesonen
- Division Occupational MedicineFinnish Institute of Occupational HealthHelsinkiFinland
| | - Marie L. A. Schuttelaar
- Department of DermatologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
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Dear K, Palmer A, Nixon RL. Allergic contact dermatitis to phenol-formaldehyde resin at a single tertiary dermatology centre. Contact Dermatitis 2021; 85:26-31. [PMID: 33382093 DOI: 10.1111/cod.13771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Phenol-formaldehyde resin 2 (PFR2) has been shown to be a useful marker of contact allergy (CA) to various phenol-formaldehyde resins. These compounds are used in several industries as solids, powders, or semisolid resins, and are known to be sensitizing agents. OBJECTIVES The aims were to investigate contact allergy to PFR2 in a single tertiary dermatology centre, to examine associated simultaneous allergic reactions, and to identify cases of allergic contact dermatitis (ACD) to PFR2. METHODS A retrospective study was performed of patients patch tested to PFR2 between 1 January 2003 and 17 June 2020. RESULTS In all, 337 of 7922 patients were tested to PFR2 and 16 (4.7%) reacted. Of those 16 individuals, six (37.5%) had a relevant reaction (1.8% of total). Simultaneous allergic reactions were noted to colophonium in eight (50.0%) patients, Myroxylon pereirae in five (31.3%), and fragrance mix I (FMI) of three cases (18.8%). CONCLUSION Contact allergy to PFR2, even in a selected population of patients, is uncommon. However, patients exposed to plastics and glues, or who work with wood products should be routinely patch tested to a plastics and glues series containing PFR2. We recommend that all centres include PFR2 in their plastics and glues series.
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Affiliation(s)
- Kate Dear
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Victoria, Australia
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Victoria, Australia
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11
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Aalto-Korte K, Pesonen M. Printers' occupational contact dermatitis: 12-year data from the Finnish Register of Occupational Diseases. Contact Dermatitis 2021; 85:233-234. [PMID: 33598983 DOI: 10.1111/cod.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Kristiina Aalto-Korte
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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12
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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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Pesonen M, Koskela K, Aalto-Korte K. Hairdressers' occupational skin diseases in the Finnish Register of Occupational Diseases in a period of 14 years. Contact Dermatitis 2020; 84:236-239. [PMID: 33104233 DOI: 10.1111/cod.13732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hairdressers have a high risk of occupational contact dermatitis caused by exposure to wet work and allergens in hairdressing chemicals. OBJECTIVES To examine the distribution of diagnoses of occupational skin diseases (OSDs) and their main causes in hairdressers based on a national register data on occupational diseases. METHODS We retrieved cases of recognized OSDs in hairdressers from the Finnish Register of Occupational Diseases (FROD) in years 2005-2018. RESULTS During the 14-year period, a total of 290 cases of recognized OSD in hairdressers were registered in the FROD. Allergic contact dermatitis (ACD) was diagnosed in 54%, irritant contact dermatitis in 44%, and contact urticaria (CU) in 5% of them. ACD was most commonly caused by hair dye products and their ingredients (N = 57), persulfates (N = 35), and preservatives (N = 35; mainly isothiazolinones). Acrylates emerged as hairdressers' occupational contact allergens (N = 8) probably due to introduction of structure nails into hair salons. Persulfates was the most common cause of CU. CONCLUSIONS ACD was the most common OSD in hairdressers. Our analysis confirms that preservatives are important causes of ACD in hairdressers in addition to hair dye products and persulfates. Acrylates emerged as hairdressers' occupational contact allergens, but contact allergy to perming agents remained rare.
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Affiliation(s)
- Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
| | - Kirsi Koskela
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Tampere, Finland
| | - Kristiina Aalto-Korte
- Occupational Health Unit, Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
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14
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Uter W, Bauer A, Belloni Fortina A, Bircher AJ, Brans R, Buhl T, Cooper SM, Czarnecka-Operacz M, Dickel H, Dugonik A, Geier J, Giménez-Arnau AM, Gonçalo M, Johansen JD, Johnston GA, Mahler V, Rustemeyer T, Sanchez-Perez J, Schuttelaar MLA, Simon D, Spiewak R, Valiukevičienė S, Weisshaar E, White IR, Wilkinson M. Patch test results with the European baseline series and additions thereof in the ESSCA network, 2015-2018. Contact Dermatitis 2020; 84:109-120. [PMID: 32945543 DOI: 10.1111/cod.13704] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series. OBJECTIVES To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments. METHODS Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control. RESULTS In the 4 years (2015-2018), data from 51 914 patients patch tested with the European baseline series (EBS) of contact allergens were analysed. Contact allergy to nickel was most frequent (17.6% positive), followed by contact allergy to fragrance mix I (6.9%), methylisothiazolinone (MI; 6.2%), and Myroxylon pereirae resin (balsam of Peru; 5.8%). CONCLUSIONS While the prevalence of MI contact allergy decreased substantially following regulatory intervention, the persistently high levels of allergy to metals, fragrances, other preservatives, and rubber chemicals point to problems needing further research and, potentially, preventive efforts. Results with national additions to the baseline series provide important information on substances possibly to be considered for inclusion in the EBS.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Centre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Anna Belloni Fortina
- Dermatology Unit, Department of Paediatrics, University of Padova, Padova, Italy
| | - Andreas J Bircher
- Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Faculty of Biomedicine, Università della Svizzera Italiana, Lugano, Switzerland
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Susan M Cooper
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Aleksandra Dugonik
- Department of Dermatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Johannes Geier
- Information Network of Department of Dermatology, University Medical Center, Göttingen, Germany
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar. Universitat Autònoma and Pompeu Fabra, Barcelona, Spain
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Skin and Allergy, Gentofte Hospital, Hellerup, Denmark
| | | | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Rustemeyer
- Department of Dermatology, Free University of Amsterdam, Amsterdam, The Netherlands
| | - Javier Sanchez-Perez
- Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ian R White
- Cutaneous Allergy Team, St. John's Institute of Dermatology, Guy's Hospital, London, UK
| | - Mark Wilkinson
- Dermatology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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15
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Aalto‐Korte K, Koskela K, Pesonen M. Construction workersʼ skin disorders in the Finnish Register of Occupational Diseases 2005‐2016. Contact Dermatitis 2020; 83:437-441. [DOI: 10.1111/cod.13648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 11/27/2022]
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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